Mammotome旋切术在老年乳腺隐匿性肿块诊治中的应用

Application of mammotome in the diagnosis and treatment for elderly women with impalpable breast lesions

目的 总结探讨超声引导下Mammotome旋切技术在老年乳腺隐匿性肿块诊治中的价值及其特点.方法 256例（60～71岁,中位年龄65岁）女性患者共发现361处隐匿性肿块,超声BI-RADS分级为Ⅲ～Ⅳb级.在超声引导下行Mammotome切除活检术,术后病理明确诊断,如是恶性则及时手术根治,定期随访,记录并发症情况和满意度.结果 纤维腺瘤及纤维腺瘤形成趋势212处,乳腺囊肿31处,乳腺增生98处,导管内乳头状瘤5处.乳腺癌15例（占总病例数的5.8%,高于不考虑年龄因素的总体恶性检出率2.3%,P〈0.05）.活检成功率100%,取材充分,满足病理诊断需求,诊断乳腺癌的敏感性和特异性均为100%.良性病变完全切除率为100%.并发症发生率9.3%,以血肿和淤斑为主.患者满意度为93.1%.结论 这一技术可以为这类老年患者提供及时、精确和切除式活检,获得病理诊断,治疗性切除良性病灶,具有重要临床价值.

Objective To explore the value and features of ultrasound-guided mammotome in the diagnosis and treatment of elderly women with impalpable breast lesions. Methods 361 impalpable breast lesions were found in 256 patients, 60-71 years （ median is 65 years old ）, ultrasonograpby classification was Ill ~ 1Vh. The lesions were biopsied and excised with ultrasound-guided Mammotome system. The cases whose pathological reports were malignant were radical operated in time. Follow-ups were performed periodically, while the complcations and satisfaction rate of patients were recorded. Results There were 212 fibroadenoma and neoplasty, 31 breast cysts, 98 hyperplasia, 5 intracanalicular papilloma, and 15 breast cancers （detection rate was 5.8 % of totalpatients, obviously higher than the gross detection rate of all patients）. Biopsy achievement ratio was 100 %. The specimen were sufficient to meet the pathologists＇ needs. The rates of sensibility and specificity of breast cancer diagnosis were all 100%. Complete resection rate of benign lesions was also 100 %. Complications rate was 9.3%, mainly with haematoma and ecchymosis. Patients＇ satisfaction rate was 93.1%. Conclusions Mammotome technique can realize prompt, precise and excisional biopsy for elderly patients to obtein pathological diagnosis and to eliminate benign lesions.