超声引导下乳腺肿物Mammotome切除活检1200例报告

Application of ultrasound-guided Mammotome system in the excision of breast lesions:a series of 1200 patients

目的总结在超声引导下乳腺肿物Mammotome切除活检的效果及应注意的问题、手术操作技巧。方法对2005年10月至2009年9月中国人民解放军总医院普通外科1200例病人2836个超声检查BI-RADS3～4级的乳腺病灶(3级2615个,4级221个)实施了Mammotome切除活检手术。结果 1190例病人的2826个病灶为良性。乳腺癌9例,分别接受乳腺癌保乳或改良根治术。交界性叶状肿瘤1例,再次手术行局部扩大切除术。良性病变者术后3、6个月时复查,随访时间3～48个月,平均16个月。乳腺外观均无变化,触觉正常。有9例(0.32%)出现病变残留。结论超声引导下Mammotome切除活检可以彻底切除乳腺良性肿瘤,严格掌握Mammotome切除活检手术的适应证、清晰的立体观念、超声图像与肉眼观察手术标本相结合,有助于彻底切除肿瘤。

Objective To evaluate the effectiveness of complete removal of clinically benign breast lesions with the ultrasound-guided Mammotome system. Methods The excision of 2836 lesions in 1200 patients was performed with Mammotome system under the guidance of ultrasound between October 2005 and September 2009. The lesions were category 3 （n=2615）or 4 lesions（n=221） as determined by ultrasound imaging according to Breast Imaging Reporting and Data System （BI-RADS） .Results Two thousand eight hundred and twenty-six lesions were completely as demonstrated by the follow-up ultrasound examination. The patients with breast cancer and pyllodes tumors received mastectomy or conservation. Follow-up time ranged from 3 to 48 months and an average of 16 months. Nine patients appeared with residual lesions （0.32%）. Conclusions Ultrasound-gnided Mammotome system can remove benign breast tumor completely. Holding indications of the Mammotome excision strictly, good anesthesia during operation, clear idea of three-dimensional and combined ultrasound images with the surgical specimens could help to remove the tumor completely.