超声引导Mammotome微创旋切系统在多发乳腺肿物中的应用

Ultrasonography-guided Mammotome System in Minimally Invasive Surgery for Multiple Breast Lesions

目的探讨超声引导Mammotome微创旋切系统对乳腺多发肿物进行微创切除的治疗价值。方法 2005年10月～2009年10月,超声引导下对183例多发乳腺肿物的893个肿物进行Mammotome微创旋切手术。结果全部肿物均采用Mammotome微创旋切,术后病理诊断纤维腺瘤或纤维腺病伴腺瘤形成634个,纤维腺病189个,导管内乳头状瘤42个,硬化性腺病18个,乳腺囊肿6个,导管上皮不典型增生4个。术后并发症:血肿4例,皮下瘀斑25例,乳头溢血5例。术后随访3～48个月,其中<1年74例,1～<2年70例,2～<3年27例,3～4年12例。切口小而隐蔽,乳房无变形,肿瘤残留7例(3.8%,5例为术后1年内出现,2例为术后1年半出现)。结论应用超声引导Mammotome旋切术切除乳腺多发病灶效果好,微创优势明显,操作简单、安全,值得推广。

Objective To investigate the value of minimally invasive surgery by using ultrasonography-guided Mammotome system for multiple breast lesions excision. Methods Between October 2005 and October 2009,183 cases of breast lesions（893 lesions in total） underwent minimally invasive excision with a Mammotome system guided by ultrasonography. Results The procedure was completed by the Mammotome system in all the cases.Postoperative pathological examination showed fibroadenoma or fibroadenosis combined with fibroadenoma in 634 lesions,fibroadenosis in 189,intraductal papilloma in 42,sclerotic adenosis in 18,breast cyst in 6,and atypical ductal hyperplasia in 4.After the operation,4 patients developed hematoma,25 cases showed subcutaneous ecchymosis,and 5 patients had nipple suffusion.The patients were followed up for 3 to 48 months（1 year in 74 cases,1-2 years in 70 cases,2-3 years in 27 cases,and 3-4 years in 12 cases）.The cosmetic outcomes of the procedure were satisfying.During the period,7 cases（3.8%） showed residual tumor tissues in 1（5 cases） or 1.5 years（2 cases）.Conclusions Ultrasonography-guided Mammotome vacuum-assited biopsy device is a minimally invasive,safe,and simple method for the excision of multiple breast lesions and cosmetology.