麦默通微创旋切活检系统在乳腺病变中应用的体会

Experience in the diagnosis and treatment of breast lesions with ultrasound-guided Mammotome biopsy

目的 总结麦默通微创旋切活检系统在乳腺病变中的应用经验。方法 收集2002年11月至2005年11月采用麦默通微创旋切技术行乳腺病变诊治63例患者的病历资料，对其手术适应证、手术方法及注意事项进行分析。结果乳腺病变患者63例，共计93处乳腺肿块，大小为0．5～2．5cm，每个肿块平均旋切次数为15次（6～33次），旋切时间平均22分钟（10～55分钟）。术中B超检查证实肿块完全切除。除1例出现乳房内血肿和2例局部皮下淤血外，无其他并发症。乳房皮肤表面仅留下3-5mm微小创口。病理结果显示恶性病变4例（6，3％，其中浸润性导管癌3例，导管内癌1例），其余为良性病变（导管内乳头状瘤1例，纤维腺瘤5例，乳腺腺病或乳腺增生症53例）。术后临床和超声检查随访未发现肿块复发。结论麦默通旋切活检系统是一项微创、安全、准确的乳腺病变活检方法。另外，对小的乳腺纤维腺瘤（小于2．5cm）也是一种可选择的治疗手段，但有必要进行进一步的临床研究。

Objective To summary the experience in the diagnosis and treatment of breast lesions with ultrasound guided Mammotome biopsy. Methods The data of 63 patients who underwent an ultrasound-guided minimally invasive excisional breast biopsy were collected from November 2002 to November 2005 and the indications, procedures and complications of Mammotome-biopsy were also analyzed. Results There were 93 lesions in 63 patients who presented with breast lesions. All the 93 lesions were excised. The size of the lesions was ranged from 0.5cm to 2.5cm.. The average time for excision of each lesion was 22 minutes（ range from 10min to 55min）. The complete removal of lesions was demonstrated by uhrasonography. In all but one case with hematoma in the breast and two cases with bruise, no other complications were found. Four patients were diagnosed malignant lesions（3 invasive duct carcinomas and one DCIS）, the remainder had benign pathology including one intraductal papilloma, 5 fibroadenomas, 53 fibrocystic hyperplasias or adenosises. The patients were followed up after Mammotome biopsy by physical examination and uhrasonography, no lumps were found. Conclusions The ultrasound guided Mammotome-biopsy is a minimally invasive, safe and accurate technique for diagnosing of breast lesions. In addition, it may be regarded as a therapeutic alternative for small fibroadenomas （〈2.5cm） ,but further clinical study was warranted.