乳腺隐匿性病灶活检病例的选择

The Choice of Non-palpable Breast Lesion Biopsy Cases

目的探讨乳腺隐匿性病灶活检病例的合理选择。方法回顾分析53例临床触诊阴性,而乳腺钼靶照片发现有可疑病灶的病例,术前均按美国放射学会BI-RADS的分型标准对X线征象进行判读。结果X线表现为孤立模糊小结节状影12例,小结节状影伴微细钙化2例,不规则致密影并簇状钙化6例,单纯簇状细小钙化19例,局灶性致密影9例,放射状毛刺影2例,局部腺体结构扭曲3例。按BI-RADS的分型标准,在初次判读中归为Ⅱ级的6例,Ⅲ级26例,Ⅳ级14例,Ⅴ级7例。病理结果为恶性病变30例(56.6%),良性病变23例(43.4%)。术后分期:T0期21例,T1期9例。结论准确评估乳腺隐匿性病灶的性质,有针对性地选择病例进行活检,可避免对乳腺良性病变的患者进行不必要的创伤性组织学检查,这对提高患者的生活质量具有重大意义。

OBJECTIVE To discuss the reasonable choice of Non-palpable breast lesion biopsy eases. METHODS A retrospective analysis of 53 cases that clinical non-palpable but found suspicious lesions on breast mammography photos, preoperative radi 0 therapy according to the United States Institute of BI-RADS sub-standard X-ray signs for their judgment. RESULTS X-ray showed isolated small nodular fuzzy video of 12 cases, smallnodular shadow with micro-calcification two cases, irregular and video compact cluster calcification 9 eases, only a small cluster calcification in 19 cases, 9 cases of focal dense shadow, radial burr shadow 2 cases, local gland structural distortion 3 cases. By BI-RADS classification standards, in the initial judgment have 6 cases return for grade Ⅱ , 26 cases for Ⅲ , 14 cases for Ⅳ, and seven cases for Ⅴ. Pathology results： 30 cases of malignant lesions（56.6%）, after staging： To period of 21 cases, T0 period of 9 cases： benign lesions in 23 cases （43.4%） . CONCLUSIONS The accurate assessment the nature of the non-palpable breast lesion, targeted to select cases for biopsy, can avoid the large number of patients with benign breast lesions of the unnecessary trauma of the organization diagnosis, there is great practical significance for improving the quality of the patients life.