立体定位Mammotome穿刺活检诊断乳房可疑恶性钙化的研究

Stereotactic guided mammotome biopsies in diagnosis of suspicious breast microcalcifications

目的探讨钼靶立体定位麦默通手术在乳房钙化灶诊断中的应用。方法收集2007年11月至2008年12月北京大学第三医院院收治的21例未触及乳房肿物的乳房钙化灶病例,年龄28～67岁,平均46.6岁。行钼靶立体定位麦默通穿刺活检手术。结果共切除乳房钙化灶29个。其中15个病灶为局限性簇状钙化灶,直径≤1cm,15个局限性钙化灶均完整切除。4例病人5个病灶病理证实为导管内癌,其余24个病灶病理证实为乳腺增生症,7个病灶表现为纤维囊性增生,有3个病灶伴有不同程度的导管上皮增生,1例伴有乳头状瘤形成。术后1例发生了穿刺部位血肿,自然吸收。全部病例均得到随访,平均9个月,4例乳腺癌病人行乳房切除,无复发,其余17例穿刺部位无肿块及陈旧血肿,3例复查钼靶未见可疑恶性征象。结论钼靶立体定位引导麦默通穿刺手术诊断乳房钙化灶,准确、微创、安全。

Objective To evaluate the clinical application of stereotactic guided Mammotome biopsy in the diagnosis of breast microcalcifications. Methods During November, 2007 and December, 2008, we diagnosed and treated 21 patients with 29 untouched calcification lesions, aged 28 to 67 with an average of 46.6. Excision or biopsy of the lesions was performed using Mammotome biopsy under stereotactic guidance, and then all cases were followed up in 1-9 months. Results 29 lesions from 21 patients were excised with stereotactic guided Mammotome biopsy. 15 lesions completely removed appeared as clustered calcifications in diameter 〈1cm. 5 lesions in 4 patients were diagnosed as DCIS, the others were showed to be hyperplasia, in which 7 lesions appeared as fibrocystic hyperplasia, 3 lesions accompany with varying degrees of ductal epithelial hyperplasia, and I lesion with papilloma formation. I patient after operation appeared hematoma at the puncture site, which absorbed naturally after 2 weeks.. In the follow-up study, 4 patients undergoing mastectomy appeared without recurrence, and others show no signs of malignancy. Conclusion Stereotactic guided Mammotome biopsy is position fixed accurately and minimally invasive to breast surgery, especially suitable for breast microcalcification.