全数字化乳腺X线摄影及立体定位系统在乳腺导管内癌中的应用价值

Value of Full Field Digital Mammography and Image Guided Stereotactic Breast Biopsy for Ductal Carcinoma in Situ

目的探讨全数字化乳腺摄影及X线立体定位系统在乳腺导管内癌(DCIS)中的临床应用价值。资料与方法经手术、病理证实的DCIS 24例。全部病例经全数字化乳腺摄影检查,其中21例表现为微钙化,应用俯卧式X线立体定位系统行病灶术前穿刺活检、切除。结果 24例中,X线表现为微钙化21例,其中单纯钙化18例,钙化伴局灶性非对称性致密2例,钙化伴局部结构扭曲1例;1例X线表现为边缘呈星芒状的小肿块;1例乳腺X线摄影仅见乳晕区皮肤增厚;X线表现阴性1例。结论全数字化乳腺摄影使乳腺细微结构的显示率及分辨率得到大幅度的提高,越来越多乳腺微钙化病灶被发现,术前结合X线立体定位术活检能发现更多DCIS,使其得以早期治疗,为提高乳腺癌治愈率和广泛开展保乳手术、提高患者的生活质量奠定基础。

Objective To access the value of full field digital mammography and image guided stereotactic breast biopsy for DCIS（ductal carcinoma in situ）.Materials and Methods 24 cases of DCIS identified by mammography were enrolled,the mammogrphic and pathologic findings were compared.21 microcalcification lesions received guided stereotactic biopsy and excision in prone position.Results In mammography of the 24 cases,21 showed microcalcification,which included 18 cases of microcalcification only,2 cases of microcalcification with focal asymmetry and 1 case of microcalcification with architectural distortion.In other 3 cases,1 showed small stellate mass,1 showed thicken in skin of areola and 1 had negative findings.Conclusion Full field digital mammography highly improves the resolution of breast microstructure.More and more microcalcification lesions are revealed.With image guided stereotactic breast biopsy before resection,more non-palpable DCIS can be revealed and treated in early stage,which will lay the foundation for improving breast cancer cure rate,widely promoting breast conserving surgery and improving the patient life quality.