X线导引下乳腺钙化导丝定位活检的应用价值  

The application value of X-ray guided wire localization open biopsy of breast calcification

作　　者：魏冉[1] 张蓓[1] 胡文娟 王兰云 王庆兵 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025 [2]上海市瑞金医院集团闵行区中心医院放射科,上海201100

出　　处：《中国癌症杂志》2011年第6期473-477,共5页China Oncology

基　　金：上海市科学技术委员会自然科学基金资助项目(No:09411962800)

摘　　要：背景与目的:钙化是早期乳腺癌最易察觉的征象,X线发现可疑恶性钙化灶可行X线引导下经皮穿刺导丝定位开放活检。本研究探讨乳腺可疑恶性钙化灶X线引导下导丝定位开放活检的应用价值。方法:对32例共37个临床触诊阴性而X线检查发现有可疑恶性钙化灶的患者,行X线引导下导丝定位开放活检术。所有活检切除标本均立即行X线摄片,确定切除是否完全,再送病理学检查。结果:32例患者共37个病灶有7个为恶性,其中5个导管内原位癌(ductal carcinoma in situ,DCIS),2个浸润性导管癌(invasive ductal carcinoma,IDC);30个良性病灶,其中6个导管内不典型增生(atypical ductal hyperplasia,ADH),14个上皮增生,10个腺病,总的恶性率为18.92%。对DCIS病灶进行了患侧乳腺局部扩大切除乳房保留术,对IDC病灶进行了患侧乳房改良根治术。结论:对临床触诊阴性而X线检查发现的可疑恶性钙化灶应行X线引导下导丝定位开放活检,可提高早期乳腺癌及临床触诊阴性乳腺癌的检出率及诊断率,为患者临床治疗方案的制定提供依据。Background and purpose:Calcification is the most sensitive sign in early breast cancer,X-ray suspicious malignant calcifications should receive X-ray guided wire localization open biopsy.The purpose of this study was to explore the application value of X-ray guided wire localization open biopsy of breast abnormal calcifications.Methods:37 lesions in 32 patients with non-palpable abnormal calcifications on mammography underwent X-ray guided wire localization open biopsy in our study.The abnormal calcifications in excited specimen were checked by X-ray again.The preoperative assessment of mammography was reviewed and a correlation with pathological examination of the surgical specimens was reported.Results:A total of 37 wire localization excision biopsies were carried out in 32 female patients.The overall malignancy rate was 18.92%(7/37).Five of these patients were ductal carcinoma in situ(DCIS);2 were invasive ductal carcinoma(IDC);6 were atypical ductal hyperplasia(ADH);14 were epithelial hyperplasia;and 10 were adenosis.Out of 35 lesions which were suspicious lowly malignancy on preoperative assessment,5 malignancies were found,while in the 2 lesions thought to be highly suggestive of malignancy on preoperative assessment,there were 2 malignancies,giving a sensitivity of 28.57% and a specificity of 100%.The X-ray showed that all lesions were completely resected.5 patients with DCIS were treated with breast conservation surgery,and 2 patients with invasive ductal carcinoma were treated with modified radical mastectomy.Conclusion:Patients with diagnoses of non-palpable calcifications by mammography should undergo X-ray guided wire localization open biopsy,which can increase the diagnosis rate of early breast cancer and improve the prognosis.

关 键 词：乳腺可疑恶性钙化 早期乳腺癌 导丝定位 活检切除 

分 类 号：R73[医药卫生—肿瘤]