真空辅助旋切微创术对超声检查良性乳腺实性肿块的诊治价值

The value of vaccum-assisted breast biopsy system(Mamotome) in diagnosis and treatment of benign solid breast masses diagnosed by ultrasound

目的探讨真空辅助旋切微创手术对超声检查为良性乳腺实性肿块的诊治价值。方法收集2008年1月至2009年6月在本院乳腺病中心超声检查为乳腺影像报告和数据系统分级(Breast Imaging Reporting and Data System,BI-RADS)2、3、4级的良性乳腺实性肿块患者831例,所有患者行真空辅助旋切微创手术。对患者的超声检查、手术及病理资料进行回顾性分析。结果根据超声检查BI-RADS分级,2级167例、3级588例、4级76例。831例患者共检出肿块1383处,所有乳腺肿块均被准确、完全切除,全部患者切口隐蔽,乳房无变形,有较好的外观美观效果。831例患者中,良性病变822例,占所有病例的98.92%,乳腺癌9例占所有病例的1.08%,其中临床分期I期8例,Ⅱa期1例.418例不可扪及肿物患者中检出1例乳腺癌,占不可扪及患者的0.24%,占所有病例的0.12%(1/831)。413例可扪及肿物患者中检出8例乳腺癌,占可扪及患者的1.94%,占所有病例的0.96%(8/831)。588例BI-RADS3级病例中检查出3例乳腺癌,76例BI-RADS4级病例中检查出6例乳腺癌。结论真空辅助旋切微创手术诊治超声检查良性乳腺实性肿块不仅美容效果好,而且定位准确能全切除良性病变,更重要的是能检出临床上考虑良性肿块中的早期乳腺癌。

Objective To discuss the practical value of vaccum-assisted breast biopsy system（Mammotome）in diagnosis and treatment of benign solid breast masses diagnosed by ultrasound.Methods From January 2008to June 2009,831patients who were diagnosed by ultrasound with BI-RADS category（Breast Imaging Reporting and Data System）2,3and 4benign solid breast masses and underwent operation with vaccum-assisted breast biopsy system were collected.The data of their ultrasound examination,operation and pathologic examination were retrospectively studied.Results According to BI-RADS category,167cases were classified as BI-RADS 2,588as BI-RADS 3and 76as BI-RADS 4.In the 831patients,a total of 1383masses were detected,and all the breast masses were resected exactly and completely.All incisions were concealed,and no deformation occurred.All patients had nice breast appearance.Of the 831cases,822had benign breast masses,accounting for 98.92% of call cases;nine cases had breast cancer,accounting for 1.08%of all cases,with eight cases in stage I breast cancer and one in stage IIa.Among the 418cases of nonpalpable breast masses,one was detected with breast cancer,holding 0.24% of all non-palpable cases and 0.96%of all cases.Among the 413cases of palpable masses,eight were detected with breast cancer,holding 1.94%of palpable cases and 0.96% of all cases.Among the 588cases of BI-RADS category 3,three were detected with breast cancer.Among the 76cases of BI-RADS category 4,six were detected with breast cancer.Conclusions Vaccum-assisted breast biopsy system used for ultrasound-diagnosed benign solid breast masses can obtain accurate location,complete removal of the masses and good cosmetic effect.More importantly,early breast cancer that are diagnosed as benign masses by ultrasound can be identified by vaccum-assisted breast biopsy system.