Clinical application of mammotome minimally invasive biopsy system under the guide of ultrasound on nonpalpable breast Lesions
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摘要:
目的探讨超声引导下麦默通旋切系统对触诊阴性乳腺病灶的诊断优势及意义。 方法2014年1月~2015年9月我院所收治经超声诊断而临床触诊阴性病灶的341例患者采用超声引导下麦默通旋切系统旋切并对其中164例患者进行了BARD活检针穿刺活检,回顾分析了相应患者的临床资料,分析了麦默通旋切系统较BARD活检穿刺针的诊治优势,同时对常见并发症进行探讨。 结果341例麦默通旋切患者穿刺成功率为100%,164例BARD活检穿刺针患者穿刺成功率为82.19%,麦默通旋切组标本病检阳性率为100%,而BARD活检穿刺针组阳性率仅为76.1%。341例患者中仅5例患者出现轻微皮下瘀斑,3例患者出现术后血肿。 结论针对触诊阴性的乳腺病灶,在超声引导下行麦默通旋切活检术具有微创、安全、成功率高、并发症少的优势,对触诊阴性乳腺病灶的诊治具有重要意义。 Abstract:Objective To assess the advantage and value of Mammotome minimally invasive biopsy system under the guide of ultrasound on Nonpalpable Breast Lesions. Methods We counted 341 patients with nonpalpable breast lesions who diagnosed by ultrasound, all the patients obtained Mammotome minimally invasive biopsy guided by ultrasound, 146 of also obtained BARD biopsy needle aspiration biopsy ,and then analyzed by pathological examination,the cause for complications was analysed and the control strategy was studied. Results The success ratios of sample choosing for Mammotome minimally invasive biopsy system and BARD biopsy needle were 100% and 82.19%, respectively.The coincident ratios of pathological diagnosis of Mammotome minimally invasive biopsy system and BARD biopsy were 100% and76.1%, respectively. In the 341 patients, only 5 patients with slight subcutaneous ecchymosis and 3 patients with hematoma. Conclusions For the nonpalpable breast lesions, Mammotome minimally invasive biopsy system under the guide of ultrasound has the advantages of minimally invasive, safe, high success rate and less complications, so it has an important significance in diagnosis and treatment of nonpalpable breast lesions -
Key words:
- nonpalpable breast lesions /
- mammotome /
- BARD puncture needle histopathology /
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表 1 旋切组与穿刺组年龄与肿物大小
特征 旋切组 粗针穿刺组 P 平均年龄(岁) 38.70(16~69) 37.83(16~69) 0.365 肿物平均大小(cm) 0.942(0.5~1.5) 0.938(0.5~1.5) 0.883 表 2 触诊阴性病灶病理诊断结果[n, (%)]
触诊阴性病灶病理类型 不典型增生 纤维腺瘤 导管内乳头状瘤 乳腺纤维腺病 浸润性导管癌 粘液腺癌 交界性分叶状瘤 非霍奇金淋巴瘤 乳腺脂肪瘤 正常组织 旋切组 17(5.0) 174(51.0) 38(11.1) 102(29.9) 6(1.8) 1(0.3) 1(0.3) 1(0.3) 1(0.3) 0 粗针穿刺组 6(4.3) 36(26.1) 17(12.3) 44(31.9) 1(0.7) 0 0 1(0.7) 0 33(23.9) 表 3 穿刺组与旋切组成功率及病理阳性率
项目 麦默通旋切组 粗针穿刺组 穿刺 成功 341(100%) 138(84.1%) 失败 0 26(15.9%) 病理结果 阳性 341(100%) 105(76.1%) 阴性 0 33(23.9%) -
[1] "李太玉, 孙晓, 王永胜, 等. 超声引导真空辅助活检对乳腺癌诊断价值 的研究[J]. 中华内分泌外科杂志, 2010, 4(1): 37-9. [2] 余松林. 医学统计学[M]. 北京:人民卫生出版社,2002: 164-78. [3] 储新年, 高福智, 张蕾. 麦默通乳腺微创手术并发症的防治[J]. 吉林医 学, 2014, 35(24): 5461-2. [4] Soluri A, Scafè R, Falcini F, et al. New localization technique for breast cancer biopsy: mammotome guidance with imaging probe [J]. Tumori, 2002, 88(3): S37-9. [5] 周丹, 叶国麟, 潘瑞琳, 等. 超声引导下麦默通旋切系统诊断不可触及 乳腺病灶的临床研究[J]. 哈尔滨医科大学学报, 2015, 49(3): 243-7. [6] Fine RE, Boyd BA, Whitworth PW, et al. Percutaneous removal of benign breast masses using a vacuum-assisted hand-held device with ultrasound guidance[J]. Am J Surg, 2002, 184(4): 332-6. [7] Chen DR, Chang RF, Chen CJ, et al. Three-dimensional ultrasound in margin evaluation for breast tumor excision using mammotome [J]. Ultrasound Med Biol, 2004, 30(2): 169-79. [8] Lacambra MD, Lam CC, Mendoza P, et al. Biopsy sampling of breast lesions: comparison of core needle- and vacuum-assisted breast biopsies[J]. Breast Cancer Res Treat, 2012, 132(3): 917-23. [9] 侯新燕, 黄晓玲, 高宇, 等. BI-RADS对超声引导下乳腺穿刺活检的 指导价值[J]. 中国超声医学杂志, 2011, 27(9): 786-9. [10] 吕晶, 张青松, 陈征. 麦默通微创旋切活检系统在乳腺触诊阴性病变 诊断治疗中的应用[J]. 中国肿瘤临床, 2008, 35(4): 196-7, 205. [11] Diebold T, Hahn T, Solbach C, et al. Evaluation of the stereotactic 8G vacuum-assisted breast biopsy in the histologic evaluation of suspicious mammography findings (BI-RADS IV) [J]. Invest Radiol, 2005, 40(7): 465-71. [12] 胡薇, 樊佳裔, 张庆萍, 等. 不同浓度肾上腺素对麦默通微创旋切术后 血肿的预防作用[J]. 中华乳腺病杂志:电子版, 2011, 5(2): 222-4