全数字化俯卧式X线立体钢丝定位术在乳腺微钙化病灶中的应用价值

Value of Steel Wire Implantation with Prone Table Stereotactic Digital Mammography in the Detection of Microcalcification of the Breast

目的:探讨X线立体定位钢丝引导切取活检术(SWLB)对乳腺微钙化病灶的临床应用价值。方法:回顾性分析2007年5月至2008年5月南方医科大学附属深圳妇幼保健院45例行SWLB活检的乳腺隐匿性病变,所有病例均为临床触诊阴性而乳腺X线摄影发现微钙化病灶,将活检标本病理结果与X线表现进行对照。结果:45例SWLB活检组织标本病理结果中恶性病变13例(28.9%),其中包括导管原位癌3例(23.1%),导管原位癌伴微浸润4例(30.8%),浸润性导管癌5例(38.5%),导管内乳头状癌1例(7.7%);良性病变32例(71.1%),其中包括导管上皮重度非典型增生2例(6.3%)。结论:SWLB可准确引导切检临床阴性的乳腺微钙化病灶,明确乳腺微钙化的性质,提高早期乳腺癌的检出率。

Objective： To explore the clinical value of stereotactic wire-localized biopsy （SWLB） in digital mammography in the detection of microcalcification of the breast. Methods： A total of 45 patients with nonpal- pable breast lesions which were positive for microcalcification by mammography but could not be detected clinically underwent SWLB. Their mammography findings were analyzed in detail with pathology. Results： Among the 45 cases, 13 cases （28.9%） had malignant lesions including ductal carcinoma in situ in 3 cases （20.1%）, ductal carcinoma in situ with microinvasion in 4 cases （30.8%）, invasive ductal carcinoma in 5 cases （38.5%） and intraductal papillary carcinoma in 1 case （7.7%）. Thirty-two cases （71.1%） had benign lesions, 2 cases （6.3%） of which were severe atypical hyperplasia. Conclusion： SWLB can accurately guide the surgical excision of nonpalpable breast microcalcification lesions and diagnose microcalcifications exactly, which is helpful for increasing the detection rate of early-stage breast cancer.