乳腺内不可触及病灶的定位活检应用价值  

Clinical Application Value of Localization Biopsy of Nonpalpable Breast Lesion by Mammotome or Mammography

作　　者：罗智勇[1] 王立平[2] 叶蕾[2] 刘玥[1] 胡晓鹏[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院甲乳外科,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院超声科,湖北武汉430030

出　　处：《现代生物医学进展》2014年第33期6513-6516,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81172512)

摘　　要：目的:探讨乳腺内不可触及病灶(NPBL)的定位活检技术及其在乳腺癌早期诊断中的临床应用价值。方法:对彩超发现的4459个和钼靶发现的25个NPBL分别行麦默通旋切和钩丝定位活检,确定病灶的病理类型。结果:4459个NPBL中3196个病灶为乳腺腺病或伴纤维腺瘤样结节(71.7%),1198个为纤维腺瘤(26.9%),11个为分叶状肿瘤(0.2%),17个为导管内乳头状瘤(0.4%),9个为乳腺导管原位癌,5个为导管原位癌伴微浸润,23个为浸润性癌(恶性占0.8%)。25个钼靶发现的NPBL中乳腺腺病13例(52%),导管原位癌7例,导管原位癌伴微浸润2例,浸润性癌3例(恶性占48%)。结论:超声引导下麦默通和钼靶引导下钩丝定位切除可以对NPBL做出定性诊断,具备创伤小、手术时间短和定位精准等特点,对提高乳腺癌的早期诊断率、降低死亡率具有一定的临床应用价值。Objective： To investigate techniques of localization biopsy of nonpalpable breast lesions and clinical application value of early diagnosis of breast cancer. Methods： 4459 and 25 nonpalpable breast lesions respectively detected by ultrasonography and mammography were removed by mammotome or wire localization, and then confirm types of pathology. Results： 3196 focuses in 4459 nonpalpable breast lesions detected by ultrasonography were adenosis of mammary glands with or without fibroadenoma（71.7%）, 1198 focuses were fibroadenoma（26.9%）, 11 focuses were phyllodes tumor（0.2%）, 17 focuses were intraductal papilloma（0.4%）, 9 focuses were ductal carcinoma in situ,5 focuses were ductal carcinoma in situ with microinvasion, 23 focuses were invasive carcinoma（malignant amount to 0.8%）. 13 focuses detected by mammography were adenosis of mammary glands（52%）, 7 focuses were ductal carcinoma in situ, 2 focuses were ductal carcinoma in situ with microinvasion, and 3 focuses were invasive carcinoma（ malignant amount to 48%）. Conclusions： Mammotome and wire localization biopsy became preferential techniques to pathological diagnosis of nonpalpable breast lesions because of less injury and shorter time interval and precise localization. It can promote early diagnosis of breast cancer and reduce mortality rate, which has better clinical application value.

关 键 词：乳腺癌 不可触及病变 定位活检 

分 类 号：R323.23[医药卫生—人体解剖和组织胚胎学] R737.9[医药卫生—基础医学]