超声定位下48例隐匿性乳腺病灶精准切除  

Ultrasound-guided precise resection of 48 cases of occult breast lesions

作　　者：赵宁[1] 滕长胜[1] 

机构地区：[1]首都医科大学附属北京友谊医院普外科,北京100050

出　　处：《国际外科学杂志》2012年第11期763-765,共3页International Journal of Surgery

摘　　要：目的探讨隐匿性乳腺病灶手术活检的临床意义，确定超声定位下隐匿性乳腺病灶精准切除的操作方法，提高乳腺癌的早期诊断率。方法44例患者的48例隐匿性乳腺病灶，在超声引导下采用定位针与体表标记相结合的方法定位，按照固定的步骤进行开放手术切除。结果通过病理诊断证实病灶全部被准确切除，未发生定位针断裂、脱出等情况，术后乳房外形均未发生变化，未发生乳头乳晕坏死的并发症。病理结果：浸润性导管癌（Ⅰ期）4例，占8．3％；乳腺非典型增生15例，占31．3％；其余为乳腺腺病、乳管内乳头状瘤、乳腺纤维腺瘤、乳腺导管扩张症等良性病变。结论超声定位下隐匿性乳腺病灶的精准切除是安全有效的检查和治疗方法，需要一定的手术技巧，在提高乳腺癌的早期诊断率、降低乳腺癌的发病率、降低医疗成本、减少乳腺活检手术的并发症等方面都具有积极的意义。Objective To explore the clinical significance of occult breast lesions biopsy, determine the operating methods of ultrasound-guided precisie resection of occult breast lesions, improve early diagnosis rate of breast cancer. Methods Forty-eight occult breast lesions of 44 patients were reviewed by localization-needle and skin markers method under ultrasound-guided, and the lesions were removed surgically according to the fixed steps. Results It was confirmed that all the impalpable mammary masses were exactly excised without localization-needle fracture or prolapse through postoperative pathological diagnosis. Breast appearance had no change after the operation. No nipple-areola necrosis occurred. The pathology results showed 4 cases of invasive ductal carcinoma （Ⅰ stage）, the incidence rate being 8.3%, and 15 cases of atypical hyperplasia, the incidence rate being 31.3%. The other types were benign disease such as adenosis, intraductal papilloma, fibroadenoma and mammary duct ectasia. Conclusions Ultrasound-guided precise resection of occult breast lesions is a safe and effective diagnosis and treatment method, which needs some surgical skills. It has positive significance in improving breast cancer early diagnosis rate, reducing medical costs and decreasing breast biopsies complications.

关 键 词：乳腺疾病 超声检查 活组织检查 针吸 

分 类 号：R655.8[医药卫生—外科学]