摘要
目的：探讨钼靶X线导丝定位联合彩超引导穿刺活检对乳腺微小钙化病变的临床诊断作用，以减少乳腺外科切检后对前哨淋巴结活检（ SLNB）的影响。方法对2011年1月至2012年12月河北联合大学附属唐山市人民医院就诊的38例乳腺临床不能触及、超声阴性、X线仅有簇状或线样弥漫分布钙化的患者进行钼靶X线乳腺钙化灶导丝定位，在超声引导下沿定位导丝穿刺乳腺可疑病变组织。待病理结果回报后，进一步制定相关手术方案。结果38例病灶均定位准确，9例为乳腺癌，其中乳腺导管内癌伴微小浸润3例（3/38），导管原位癌（DCIS）6例（6/38），乳腺腺病25例（25/38），非典型增生3例（3/38），乳腺导管内乳头状瘤1例（1/38）。病理穿刺组织均能看到钙化灶，1例穿刺病理导管原位癌，术后切除活检为原位癌伴微小浸润，与术后切除病理基本相符，全组乳腺癌检出率23.7％。病理为乳腺癌患者，行前哨淋巴结活检术，均成功检测到前哨淋巴结。结论对于临床不可触及、超声阴性仅钼靶X线显示钙化乳腺病变组织，经钼靶X线导丝定位联合彩超引导钙化灶穿刺活检，定位准确，安全可行，可能减少乳腺癌对外科切检后对前哨淋巴结活检术的影响，具有一定的临床应用价值。
Objective To evaluate the clinical usefulness of mammography-guided wire localization plus ultrasound-guided core-needle biopsy of breast microcalcification and avoid the effects of preoperative excisional biopsy for patients undergoing sentinel node biopsy.Methods A total of 38 patients with unpalpable lesions , ultrasonic negativity and abnormal mammography received a guide wire under mammography and performed ultrasound-guided core-needle biopsy of breast microcalcification before preoperative excisional biopsy.Results All 38 lesions were successfully located and biopsied for pathological examination.Carcinoma was present in 9 lesions：ductal carcinoma in situ （ DCIS） （6/38） and intraductal carcinoma with early infiltration （ 3/38 ）.For 29 benign lesions , there were mastopathies （25/38）, atypical ductal hyperplasia （ ADH ） （ 3/38 ） and intraductal papiloma （ 1/38 ） .Breast microcalcification was detected in all lesions by ultrasound-guided core-needle biopsy.The detection rate of breast cancer detected was 30.8% and the diagnostic accuracy 100%.Conclusions For patients with unpalpable lesions , ultrasound negativity and abnormal mammography , mammography-guided wire-localization plus ultrasound-guided core-needle biopsy of breast microcalcification is accurate , safe and feasible.And it may avoid the effects of preoperative excisional biopsy for patients with sentinel node biopsy .The procedure is worthy of wider clinical applications.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第32期2519-2521,共3页
National Medical Journal of China
关键词
乳腺疾病
钼靶
超声
钙化
穿刺活检
Breast disease
Mammography
Ultrasound
Calcinosis
Core needle biopsy
