经皮核芯针穿刺活检乳腺巨大肿块的临床应用

The clinical application of percutaneous large core needle biopsy on large bre ast mass

目的探讨经皮核芯针穿刺活检乳腺巨大肿块的临床应用价值。方法对31例直径均大于5cm的乳腺巨大肿块行X线摄片及经皮核芯针穿刺活检。结果X线片上除5例可见恶性钙化表现外,其余病例均缺乏特征性表现。穿刺活检病理结果为乳腺癌11例,化脓性炎症9例,慢性纤维囊性乳腺病7例,结核1例;纤维腺瘤3例。1例活检为慢性纤维囊性乳腺病,术后病理诊断为慢性纤维囊性乳腺病局部癌变,,其余30例术后或随访结果均与穿刺结果相同。活检敏感性率为100%,特异性为96.8%。术中出现迷走反应1例,血肿1例。结论经皮核芯针穿刺活检是一种创面微小、操作简单、安全可靠的诊断方法,可弥补常规检查及手术切检对乳腺巨大肿块诊断的不足。

Objective An evaluation of the clinical application of percutane ous large core needle biopsy on large breast mass. Methods Mammography and percuta neous large core needle biopsy were performed in 31 cases of large breast mass. Results Apart from 5 cases showing characteristic calcification of malignancy, t he rest cases were lack of diagnostic manifestation. Needle biopsy and pathologi cal examination identified breast canner in 11 cases, suppurative mastitis in 9 case, fibrocystic mammary disorder in 7 cases, tuberculosis in 1 case, and fibro adenoma in 3 cases. Fibrocystic mammary disease was initially identified by biop sy in a case, while the following pathological diagnosis was fibrocystic mammary disorder with cancinoma in situ. Specificity rate of biopsy was 96.8%and no fa lse positive was observed. Vagotonia occurred in one case during the biopsy and hematoma in another. Conclusion Percutaneous large core needle biopsy is a less invasive, simple, safe and reliable methods in the diagnosis of the large breast mass. And it may be recommended as a complementary procedure for routine imaging modality or surgical resection.