超声引导经皮穿刺导丝定位切除乳腺隐匿性病灶的价值

Value of ultrasound guided needle-wire localization for occult breast lesions excise

目的探讨经超声引导下钩针定位对手术切除乳腺隐匿性病灶的价值。方法对触诊阴性但超声检查阳性的乳腺和腋窝隐匿性病灶进行靶向钩针穿刺固定,外科手术切除活检,分析病灶良恶性、完全切除率及超声对其诊断的敏感性和特异性,评价该方法对手术时间、术后美容效果的影响。结果61个隐匿性病灶中,恶性病灶16个(26.2%),良性病灶45个(73.8%);所有病灶均完整切除;超声对隐匿性乳腺癌的诊断敏感性93.8%,特异性91.1%。结论超声靶向钩针固定技术可以协助手术准确定位隐匿性病灶,在保证病灶完全清除的前提下缩小手术切除范围,从而早期诊断和治疗乳腺癌。

Objective To evaluate the efficacy of localization of occult breast neoplasm by needle wire under ultrasound guidance before surgical excise. Methods Fifty eight occult breast lesions and 3 enlarged axiUary lymph nodes were detected by ultrasonography, and all 61 lesions were executed hook wire localization puncture guided by ultrasound preoperatively. Results All localized lesions were removed accurately. Sixteen lesions of 61 lesions were malignant （26.2%）, including 3 lesions were situ carcinomas, 8 lesions were early stage invasive carcinomas, 4 lesions were invasive carcinomas, and 1 lesion was lymph node metastatic carcinoma. The remaining 45 lesions were benign （73.8 % ）. The sensitivity and specificity of ultrSsonography for diagnosis was 93.8 % and 91.1%, respectively. Conclusion Ultrasound - guided wire localization of breast occult lesions is not only useful in assisting surgical biopsy, but also helpful in early diagnosis and treatment of breast carcinoma.