乳腺真空辅助微创活检处理可疑恶性病灶的现状及展望  

Vacuum-assisted minimally invasive breast biopsy for managing suspicious lesions:current status and prospect

作　　者：胡薇[1] 詹璐 HU Wei;ZHAN Lu(Department of Thyroid and Breast Surgery,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学(第二军医大学)长海医院甲乳外科,上海200433

出　　处：《第二军医大学学报》2021年第5期534-537,共4页Academic Journal of Second Military Medical University

基　　金：海军军医大学(第二军医大学)教学成果立项培育项目(JPY2020A21),海军军医大学(第二军医大学)长海医院教学研究与改革项目(CHJG2020007)。

摘　　要：乳腺真空辅助微创活检(VABB)在国内广泛用于乳腺良性病灶的切除,在诊断恶性肿瘤方面也安全、准确,非常方便。在乳腺影像报告和数据系统(BI-RADS)3级病损中,对于扁平上皮非典型病变、经典小叶肿瘤、乳头病变和经核心针活检或VABB诊断的放射状瘢痕建议采用VABB切除而非开放性手术。影像引导的VABB是微钙化安全的诊断方法,并且正在向完全性切除发展。高龄、活检病灶有残留、伴有不典型增生及外周型导管内乳头状瘤在VABB术后需格外注意。对以小癌灶为表现的早期乳腺癌,行VABB术后仍有一定的肿瘤残留率,目前确诊恶性的肿瘤均建议进一步扩大切除。采用VABB结合前哨淋巴结活检作为乳腺癌局部治疗措施的时代尚未来到,新辅助化疗后采用VABB评估也在探索中。本文就VABB处理可疑恶性病灶的研究进展作一综述。Vacuum-assisted breast biopsy(VABB)is widely used in the excision of benign breast lesions in China.It is also safe,accurate and convenient in the diagnoses of malignant tumors.For management of breast imaging reporting and data system(BI-RADS)3 lesions,such as flat epithelial atypia(FEA),classical lobular neoplasia(LN),papillary lesion(PL)and radial scar(RS)diagnosed by core-needle biopsy(CNB)or VABB,excision by VABB is recommended in preference to open surgery.Image-guided VABB is a safe diagnostic method for microcalcification and is progressing toward complete resection.Special attention after VABB should be paid to intraductal papilloma patients who are elderly,with residual lesions,atypical hyperplasia and peripheral type.There is still a certain residual tumor rate after VABB in early-stage breast cancer with small tumor focus.Nowadays,it is recommended to further expand the resection of malignant tumors.The era of VABB combined with sentinel lymph node biopsy as local treatment for breast cancer has not come yet;VABB evaluation after neoadjuvant chemotherapy is also in exploration.This article reviews the research progress of VABB in the treatment of suspected malignant breast lesions.

关 键 词：乳腺疾病 活组织检查 真空辅助 微创手术 乳腺肿瘤 

分 类 号：R655.8[医药卫生—外科学] R737.9[医药卫生—临床医学]