微创旋切术对直径小于1cm的乳腺病灶的诊断治疗价值

The value of diagnosis and treatment of minimally invasive surgery for breast lesions less than 1 cm in diameter

目的:探讨在超声引导下利用EnCor真空辅助旋切系统的微创旋切术在乳腺直径小于1 cm、不可触及的肿物的诊断和治疗中的价值。方法:2010年8月～2011年4月对我院150例直径小于1 cm、不可触及的乳腺肿物患者的285个肿物在超声引导下进行EnCor微创旋切术,通过回顾性分析来评价其在乳腺直径小于1 cm、不可触及的肿物的诊断和治疗中的应用价值。结果:全部乳腺肿物均采用微创旋切术,术后病理学诊断:浸润性导管癌2例,导管内癌3例,不典型增生9例,乳头状瘤12例,余均为良性。2例浸润性导管癌接受外科手术及辅助治疗。3例导管内癌,9例不典型增生及12例乳头状瘤接受外科开放手术。术后无切口瘢痕,乳房外形正常,皮肤触觉无变化。术后无一例活动性出血或创口感染,皮下瘀血6例,血肿形成6例。术后3个月行超声随访无一例复发。结论:超声引导下利用EnCor真空辅助旋切系统的微创旋切术可准确活检或完整切除乳腺直径小于1 cm、不可触及的病灶,能弥补传统开放手术活检对该类乳腺病灶诊断治疗上的不足。

Objective： To explore the value of diagnosis and treatment of minimally invasive surgery for breast lesions less than 1 cm in diameter by the use of EnCor system under the guidance of ultrasound. Methods： From August 2010 to April 2011, 285 masses of 150 patients in our hospital with breast lesions less than 1 cm＇in diameter underwent minimally inva- sire surgery with EnCor system under ultrasound guided. Through a retrospective analysis, the value of diagnosis and treat- ment of minimally invasive surgery for breast lesions less than 1 cm in diameter was evaluated. Results： All of breast masses have been removed by minimally invasive surgery. In postoperative pathological diagnosis, 2 cases were invasive ductal carcinoma, 3 cases were ductal carcinoma in situ, 9 cases were atypical hyperplasia, 12 cases were intraduetal papil- loma, the rest were benign. 2 cases of invasive ductal carcinoma were treated by surgical operation and adjuvant therapy. 3 cases of ductal carcinoma, 9 cases of atypical hyperplasia and 12 cases of papillary tumors were given open surgical oper- ation. Without postoperative incision scar, the breast maintained the normal contour. There was no change skin sensitivity and no active bleeding or wound infection in all postoperative patients, subcutaneous ecchymosis in 6 cases, hematoma in 6 cases. No recurrence was found after 3 months of follow-up by ultrasonic. Conclusion： Inaccessible breast lesions less than 1 cm in diameter can be biopsy accurately or completely removal completely by minimally invasive surgery with En- Cot system under the guidance of ultrasound and minimally invasive surgery can make up for the shortfall of the traditional open operation biopsy for the diagnosis and treatment of this kind of breast lesions.