摘要
目的探讨粗针穿刺活检(core needle biopsy,CNB)诊断乳腺导管原位癌(ductal carcinoma in situ,DCIS的前哨淋巴结活检(sentinel lymph node biopsy,SLNB)结果,了解SLNB对于DCIS的临床意义。方法回顾复旦大学附属妇产科医院2012年1月至2018年12月治疗的DCIS患者临床资料,分析其SLNB结果。结果 CNB诊断为DCIS患者共169例,全部行SLNB。其中纯导管原位癌117例(69.2%),原位癌伴微浸润28例(16.6%),浸润性导管癌24例(14.2%)。保乳29例(17.2%),乳房全切140例(82.8%)。使用14/16g穿刺活检针诊断93例(55%),8 g真空负压活检系统诊断76例(45%)。与纯导管内癌组相比,微浸润/浸润性癌组中肿瘤直径>2 cm(P<0.001),伴有广泛钙化(P<0.001),14/16 g粗针穿刺(P<0.001)、乳房切除术(P=0.03)比例均高于纯导管内癌组。7例(4.1%)患者SLNB为阳性结果,全部为14/16 g穿刺活检针诊断患者,8 g真空负压活检系统和保乳手术患者SLNB结果均为阴性。结论 CNB诊断DCIS的SLNB阳性率非常低,大部分患者SLNB可能是不必要的,特别是8 g真空负压活检系统患者和保乳手术患者。
Objective To analysis the sentinel lymph node biopsy(SLNB)results of core needle biopsy(CNB)diagnosis of breast ductal carcinoma in situ(DCIS);and to understand the clinical significance of SLNB in DCIS. Methods The cases of CNB diagnosed DCIS treated in our hospital between Jan.2010 to Dec.2018 were included.The results of SLNB were analyzed. Results Of 169 patients with a CNB diagnosed DCIS,all had SLNB,among which 117(69.2%)were pure DICS,28(16.6%)were DICS with microinvasion,and 24(14.2%)were invasive ductal carcinoma. Breast conserving surgery was performed in 29 cases(17.2%),and mastectomy in 140 cases(82.8%).Ninety-three cases(55%)were diagnosed by14/16 g needle biopsy,76 cases(45%)were diagnosed by 8 g vacuum assisted biopsy system. Compared with the pure DCIS group,the proportion of tumor >2 cm(P<0.001),extensive calcification(P<0.001),14/16 g needle biopsy(P<0.001) and mastectomy(P=0.03) in the micro-invasive/invasive carcinoma group were higher than that in the pure DCIS group. SLNB was positive in 7(4.1%)patients,all were diagnosed with 14/16 g needle biopsy.The results of SLNB were negative in 8 g vacuum assisted biopsy system and breast conserving surgery patients. Conclusions The risk of clinically significant SLN metastasis following a CNB diagnosed DCIS is extremely low;SLNB is not warranted following a CNB diagnosed DCIS,particularly for patients undergoing 8-gauge vacuum assisted breast biopsy or breast conservation surgery.
作者
王富文
傅少梅
金玉春
WANG Fu-wen;FU Shao-mei;JIN Yu-chun(Department of Breast Surgery,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200011,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2020年第1期106-110,127,共6页
Fudan University Journal of Medical Sciences
