1 breast cancer is easy to misdiagnose the disease
Cystic hyperplasia occur in the 40-year-old woman before and after in order to mammary gland hyperplasia and nodules mainly part of the cancer can occur. About 10% ~ 25% of the combined nipple discharge, mostly serous, but also brown, a few to bloody, doctors in general are more concerned with nipple discharge, making the diagnosis of pathological examination is a good way further. X-ray film sizes see the round, oval-shaped shadow, density, uniformity, cysts are manifested as large spherical translucent area, a complete capsule. This disease must be confirmed by pathological diagnosis, of which active proliferation of epithelial cells in papillomatosis and dysplasia in particular vigilance, a greater chance of cancer, if necessary, to do biopsy lesions.
Hyperplasia of mammary glands called mammary dysplasia, breast, fibrocystic disease, breast pain, are most common in women, breast disease, a kind of also being a kind of the most misdiagnosed, which causes imbalance in the estrogen in vivo. The main clinical manifestations in multiple breast tenderness and breast lumps, is characterized by pain and menstrual cycles, premenstrual aggravated by the post-mitigation. See the limitations of X-ray film or a diffuse sheet, cotton wool sizes ranging from nodular shadow. See the uneven internal echo of ultrasound, low-echo area and strong echoes are woven into mesh ribbon. CT scan shows thickening of breast tissue, and nodular hyperplasia, showing flake or block, the density slightly higher than the surrounding gland, enhanced scan density of no enhancement, but this is different from breast cancer, breast cancer early is not typical, if the Clinical examination alone can be easily misdiagnosed as breast hyperplasia.
Breast Fibroadenoma is the most common benign breast tumor, because tumor texture hard, the most easily confused with breast cancer. In patients with breast fibroadenoma usually no symptoms, mostly accidentally discovered, mass 1.0 ~ 2.0 cm, round or oval shape, is characterized by the boundary clear, smooth performance, activity is good, no adhesion with the skin, slow-growing. X-ray film shows round-like mass, smooth edge can be showed lobulated, some of adenocarcinoma of calcification may occur, and breast cancer difference is that coarse calcification adenoma large, a ring, block, or patchy, breast cancer calcification of sand granular, needle-like. Enhanced CT shows uniformly enhanced adenoma, larger adenomas may have edge enhancement, this situation often misdiagnosed as breast cancer. Breast ultrasound can see inside and around the tumor had no significant color flow display.
2 easily misdiagnosed as benign breast disease
Breast tuberculosis in our country can still be seen, generally come from other parts of the secondary tuberculosis. Age of onset of 20 to 40 years old, found that breast lumps, mostly in the breast at the top, hard and tough, the boundary is unclear, 1 / 3 of skin redness, skin ulceration may have a small number of the formation of sinus, even accompanied by nipple discharge, the current only a small number of TB patients with TB symptoms of poisoning, so often misdiagnosed as cancer. Tianjin Cancer Hospital from 1954 to 1992 were treated 105 cases of breast tuberculosis, 58 cases of breast cancer misdiagnosis, misdiagnosis rate was 55.2%. X-ray film can be seen in order to seepage infiltrating mainly to mass mainly nodular type, central necrosis of the formation of irregular translucent areas cheese-like type, there are those who see the sinus sinus calcification within the shadow. Further examination can be found in primary TB lesions.
Granulomatous mastitis is a benign disease, a rare, often misdiagnosed as breast cancer, a cancer hospital between 1982 and 1992 treated 45 cases, 34 of them a routine X-ray examination, 10 cases misdiagnosed as breast cancer. With breast lumps mainly the vast majority have a history of postpartum acute mastitis, the incidence more in late lactation or weaning shortly after the tumor was solid, hard and tough, ill-defined. X-ray films and liquid crystal thermography inspection often misdiagnosed as malignant.
Breast adipose tissue necrosis occur in the middle-aged, obese, large breasts are a multi. Found in mass, more than 2.0 centimeters, quality hardware, the border is unclear, about half of the skin redness, and have adhesions, partial performance is very similar to breast cancer, 1954, the hospital treated 64 cases of ~ 1992, clinical 45 cases misdiagnosed as cancer the misdiagnosis rate of 70.3%. Diagnosis must rely on pathological examination, microscope, fatty tissue necrosis, as well as different stages of reactive connective tissue hyperplasia, inflammatory tissue infiltration and foreign body reactions.
3 Misdiagnosis analysis
Although these diseases have similarities with breast cancer, but a closer inspection, a careful analysis of the disease have differences, it is difficult to pinpoint who do may also be a clear pathological diagnosis, misdiagnosis occurs there is a reason.
Inspection is not completely certain diseases is indeed difficult to identify, early detection of breast cancer, a small mass, the performance is smooth, because there were no violations of the surrounding, so activity is good, there is no adhesion with the skin, naturally there is no orange peel syndrome, X-ray and B Chao is also very difficult to diagnosis, the most radical approach is surgical biopsy. In fact many patients can not accept, the doctors had not insisted that only “observe.”
Patients do not attach importance to a lot of women do not have anti-cancer knowledge, not to do regular medical examination, even if the breast tumor was found, because no pain, no itching and not to the doctor; need to observe the patient does not promptly return visit, the doctor failed to grasp the changes in condition, but also cause some misdiagnosis.
Doctors over-confident self-assured that some doctors practicing medicine for many years, experienced, alone fingers first touch, he will know that do not have to shoot X-ray sign, making B-, mistakenly diagnosed as breast cancer, breast hyperplasia, breast fibroadenoma, delayed treatment time, this is the most common misdiagnosis of clinical reasons, many famous doctors have a hard lesson.
4 Analysis of common errors Governance
The result is wrong rule of misdiagnosis. The breast misdiagnosed as breast hyperplasia, breast fibroadenoma, one told the patient is benign disease, do not rush to treatment, a delay of illness, and second, to do simple breast tumor resection, this procedure is often carried out in the outpatient operating room, because Doctors vigilance is not high, usually not do intraoperative frozen section only did postoperative pathology, such as pathological findings of breast cancer, hastily prepared to do radical surgery is obviously not conducive to patients.
The benign breast disease misdiagnosed as breast cancer is also often occur, first of all to patients caused tremendous mental stress, followed by the use of drugs can treat diseases such as breast tuberculosis, granulomatous mastitis, etc., were made as a breast cancer surgery, easy to lead to medical disputes.
In breast cancer treatment, there are some errors Governance:
Centralizer is a traditional Chinese medicine to treat cancer with Quxie the two great principles, the actual use it is quite stress is not obvious when the deficiency like to Quxie-based, promoting blood circulation Ruanjian Sanjie; many chemotherapy patients, are empty evil indeed, when the supplementation and attack; tumor in the late void of righteousness, evil really is no longer taken into account, only when the righting-based. Actual clinical practice, or eager to attack evil, terminally ill patients, still cast a large number of Ruanjian Sanjie, promoting blood circulation of goods, the patient bear Gong Fa, righteousness is more true, Evils Cheng Xu recurrence; or that cancer patients after operation, radiotherapy and chemotherapy After the righteousness damaged, do not look at specific circumstances of the patient, blindly nourishing. In fact, after breast cancer does not hurt the spleen and stomach, can be a little conditioning, chemotherapy patients the spleen and stomach damage, intolerant Dabu, if one wanted to mamillata moss yellow, and still use ginseng, deer horn and have intended to make people stronger, because anti-Zi greasy obstruct the stomach, so that patients do not think of diet; radiotherapy for heat-toxin, initially when the heat radiation detoxification, post-Lung-damaged, when the Ziyin lungs, to prevent radiation pneumonitis. These types of conditions are not added.
From a broad perspective, can also radiotherapy and chemotherapy classified Quxie rules, how to select a reasonable time for radiotherapy with chemotherapy, so that benefit is greater than conceal, and sometimes is very difficult. Effect of chemotherapy is limited, there are side effects, see the disease progress, regardless of patients or physicians, are eager to rise above, if the constitution is still good, choose the chemotherapy is not wrong, if the constitution is extremely poor and still use high-dose chemotherapy, there was no different from most drastic speed up the patients died; on the contrary, some patients blindly afraid of chemotherapy side effects, when the chemotherapy rather than chemotherapy, so that disease progress, the doctor submissive only in patients with the intention, will not do the work, but also wrong rule.
Error rule was also due to lack of experience with the doctor related to medicine is empirical science, for the treatment of patients with the appropriateness of a certain extent depends on the experience and should therefore be humbly from the old doctor’s advice, to specialist advice, where necessary, the relevant sections of consultations, for patients to develop a reasonable treatment plan and avoid detours.
Do not understand the latest developments can also cause false rule. Medical advances very rapidly, a medical student graduating in a few years what they have learned already out of date, we must continue to learn, and constantly update their knowledge structure, the treatment of malignant tumor present, many problems have not been conclusive, treatment is not satisfactory, a great room for development, yesterday that a good treatment programs, and today probably is not the best solution, and tomorrow may find much to be desired, it must continue to learn in order to continue to progress, an accurate diagnosis for patients the best treatment.
