中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
32期
2519-2521
,共3页
张德才%张景华%胡万宁%李红民%牛凤玲%刘景萍%赵志强%韩晓晨%张靖辉%张海萍%王洋
張德纔%張景華%鬍萬寧%李紅民%牛鳳玲%劉景萍%趙誌彊%韓曉晨%張靖輝%張海萍%王洋
장덕재%장경화%호만저%리홍민%우봉령%류경평%조지강%한효신%장정휘%장해평%왕양
乳腺疾病%钼靶%超声%钙化%穿刺活检
乳腺疾病%鉬靶%超聲%鈣化%穿刺活檢
유선질병%목파%초성%개화%천자활검
Breast disease%Mammography%Ultrasound%Calcinosis%Core needle biopsy
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。
目的:探討鉬靶X線導絲定位聯閤綵超引導穿刺活檢對乳腺微小鈣化病變的臨床診斷作用,以減少乳腺外科切檢後對前哨淋巴結活檢( SLNB)的影響。方法對2011年1月至2012年12月河北聯閤大學附屬唐山市人民醫院就診的38例乳腺臨床不能觸及、超聲陰性、X線僅有簇狀或線樣瀰漫分佈鈣化的患者進行鉬靶X線乳腺鈣化竈導絲定位,在超聲引導下沿定位導絲穿刺乳腺可疑病變組織。待病理結果迴報後,進一步製定相關手術方案。結果38例病竈均定位準確,9例為乳腺癌,其中乳腺導管內癌伴微小浸潤3例(3/38),導管原位癌(DCIS)6例(6/38),乳腺腺病25例(25/38),非典型增生3例(3/38),乳腺導管內乳頭狀瘤1例(1/38)。病理穿刺組織均能看到鈣化竈,1例穿刺病理導管原位癌,術後切除活檢為原位癌伴微小浸潤,與術後切除病理基本相符,全組乳腺癌檢齣率23.7%。病理為乳腺癌患者,行前哨淋巴結活檢術,均成功檢測到前哨淋巴結。結論對于臨床不可觸及、超聲陰性僅鉬靶X線顯示鈣化乳腺病變組織,經鉬靶X線導絲定位聯閤綵超引導鈣化竈穿刺活檢,定位準確,安全可行,可能減少乳腺癌對外科切檢後對前哨淋巴結活檢術的影響,具有一定的臨床應用價值。
목적:탐토목파X선도사정위연합채초인도천자활검대유선미소개화병변적림상진단작용,이감소유선외과절검후대전초림파결활검( SLNB)적영향。방법대2011년1월지2012년12월하북연합대학부속당산시인민의원취진적38례유선림상불능촉급、초성음성、X선부유족상혹선양미만분포개화적환자진행목파X선유선개화조도사정위,재초성인도하연정위도사천자유선가의병변조직。대병리결과회보후,진일보제정상관수술방안。결과38례병조균정위준학,9례위유선암,기중유선도관내암반미소침윤3례(3/38),도관원위암(DCIS)6례(6/38),유선선병25례(25/38),비전형증생3례(3/38),유선도관내유두상류1례(1/38)。병리천자조직균능간도개화조,1례천자병리도관원위암,술후절제활검위원위암반미소침윤,여술후절제병리기본상부,전조유선암검출솔23.7%。병리위유선암환자,행전초림파결활검술,균성공검측도전초림파결。결론대우림상불가촉급、초성음성부목파X선현시개화유선병변조직,경목파X선도사정위연합채초인도개화조천자활검,정위준학,안전가행,가능감소유선암대외과절검후대전초림파결활검술적영향,구유일정적림상응용개치。
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.