X线引导下乳腺穿刺活检对触诊阴性病变的诊断意义及其适应证

Diagnostic value and indications of X-ray guided breast biopsy of nonpalpable lesions

目的探讨X线引导下乳腺穿刺活检对于临床触诊阴性病变的诊断意义及其适应证。方法对84例乳腺X线摄影发现临床触诊阴性的乳腺病变患者进行术前三维立体钩丝定位术,并取得病理结果。对乳腺影像报告数据系统（BI-RADS）分类不同的良、恶性病变进行统计学分析。结果临床触诊阴性乳腺病变X线摄影表现为钙化、肿块、结构紊乱等。按BI-RADS分类,本组病变为3~5类,且以4类为主,占89.29%（75/84）。4B类与4C类病变恶性率差异无统计学意义（χ2=2.15,P〉0.05）,但显著高于4A类（χ2=101.7,P〈0.05）。结论对BI-RADS分类为4B以上病灶应进行X线引导下乳腺穿刺活检。

Objective To observe the diagnostic value and indication of X-ray guided breast biopsy for nonpalpable breast lesions.Methods A total of 84 patients with nonpalpable breast lesions detected with mammography underwent three-dimensional stereotactic wire localization biopsy preoperation,and pathologic results were obtained.Results Mammography of nonpalpable breast lesions showed microcalcifications,mass and lobular distortion.According to breast imaging reporting and data system（BI-RADS）,the lesions were defined as BI-RADS category 3—5,most of which were category 4（89.29%,75/84）.The malignant rates in patients defined as BI-RADS 4B and 4C were not statistically significance different（χ2=2.15,P0.05）,but were higher than patients with BI-RADS 4A（χ2=101.7,P0.05）.Conclusion X-ray guided breast biopsy should be performed in patients with breast lesions categorized above BI-RADS 4B.