乳腺X线立体定位导丝引导切除活检在触诊阴性乳腺钙化病变诊治中的应用  

Application of Mammography-Guided Stereotactic Wire Localized Open Biopsy in the Diagnosis and Treatment of Nonpalpable Breast Calcification

作　　者：田春祥 姚惠芳 刘泽宇 吕欣霖 韩晓蓉 宁平 Tian Chunxiang;Yao Huifang;Liu Zeyu;LüXinlin;Han Xiaorong;Ning Ping(Department of Breast Disease,Chengdu Women’s and Children’s Central Hospital,Chengdu 610091,Sichuan,China;Department of Radiology,Chengdu Women’s and Children’s Central Hospital,Chengdu 610091,Sichuan,China)

机构地区：[1]成都市妇女儿童中心医院乳腺科,成都610091 [2]成都市妇女儿童中心医院放射科,成都610091

出　　处：《肿瘤预防与治疗》2022年第3期267-272,共6页Journal of Cancer Control And Treatment

基　　金：成都市医学重点学科建设项目(编号:成卫健函[2019]157号)。

摘　　要：目的:探讨乳腺X线立体定位导丝引导开放切除活检在触诊阴性乳腺钙化病变诊治中的应用价值。方法:回顾性分析自2017年9月至2021年7月在我院就诊的临床查体阴性而乳腺X线检查BI-RADS分级为4~5级的可疑钙化病变患者资料,患者分为两组,分别接受体表定位法和乳腺X线立体定位导丝引导进行乳腺钙化病变开放手术切除活检,比较两组定位的准确性和保乳率。结果:共131例钙化患者接受了开放手术切除活检,双侧均有钙化病变者7例,最终138个病灶进行分析。22个病灶采用体表定位标记后开放切除活检,术中二次扩大切除率为9.1%(2/22),保乳率为42.9%(3/7)。116个病灶采用乳腺X线立体定位导丝引导开放切除活检,术中二次扩大切除率为1.7%(2/116),保乳率为52.9%(9/17)。结论:乳腺X线立体定位引导下的导丝穿刺,可精准定位可疑钙化病变,准确切除,避免二次扩大切除,提高保乳率,是适合在基层医院进行推广的一种诊断和治疗手段。Objective:To investigate the clinical significance of mammography-guided stereotactic wire localized open biopsy in the diagnosis and treatment of nonpalpable breast calcifications.Methods:The clinical data of patients with nonpalpable BI-RADS 4-5 breast calcifications shown by mammography during September 2017 to July 2021 were retrospectively analyzed.The patients were divided into two groups.Open surgical resection was performed under the guidance of body surface localization or mammography-guided stereotactic wire localization respectively.The accuracy of the localization and breast-conserving rates of the two groups were compared.Results:A total of 131 patients with nonpalpable breast calcifications underwent open surgical resection.There were 7 patients with bilateral calcifications.Finally,138 lesions were analyzed.In the body surface localization group,22 lesions were resected.The rate of extended resection was 9.1%(2/22)and the breast-conserving rate was 42.9%(3/7).In the mammography-guided stereotactic wire localization group,116 lesions were treated by open resection.The rate of extended resection was 1.7%(2/116)and the breast-conserving rate was 52.9%(9/17).Conclusion:Mammography-guided stereotactic wire localized open biopsy can accurately locate and resect suspected breast calcifications.It is a diagnostic and therapeutic method suitable for primary hospitals.

关 键 词：乳腺癌 X线立体定位 导丝引导 乳腺钙化 开放活检 

分 类 号：R730.44[医药卫生—肿瘤] R737.9[医药卫生—临床医学]