超声引导下麦默通微创旋切系统在良恶性乳腺疾病诊治中的应用

Application of Ultrasound-guided Mammotome in Breast Disease

目的探讨超声引导下麦默通(Mammotome)微创旋切系统在良恶性乳腺病灶诊治中的应用。方法回顾性研究本科室对600例乳腺患者在超声引导下进行麦默通肿块切除术,记录病理检查、手术后并发症、切口美容满意度;另外选50例术前高度怀疑乳腺癌患者行麦默通活检术,统计病理冰冻切片的正确率、所采取的治疗方法;所有患者均随访至今,平均随访时间达28月。结果 600例麦默通肿块切除术患者,皮肤切口3～4 mm,患者美容满意度高,术后血肿发生9例(1.5%),肿块残留2例(0.14%),无其它严重并发症,平均每处病灶切除时间为15 min(5～30 min),平均出血量为3 mL;50例临床可疑恶性患者所做麦默通活检术,都有最终石蜡病理证实,冰冻切片诊断正确率98%,1例不能确诊性质;32例做新辅助化疗,1例做新辅助内分泌治疗,15例做改良根治手术,2例为弥漫性炎症病变予以抗炎治疗。结论麦默通手术美容效果好,操作简单,并发症少。麦默通活检术冰冻病理诊断正确率可靠,能为乳腺癌个体化治疗选择提供可靠的依据,或对将是促进新辅助治疗发展的重要工具。

Objective To evaluate uhrasound-guided Mammotome （Mammotome） system in benign and malignant breast Disease. Methods We retrospectively analyzed the clinical data of 600 patients who were treated with under the guidance of ultrasound Mammotome mass resection, and recorded pathological examination after the surgery, postoperative complications, incision beauty satisfaction; the other 50 cases were pre-malignant breast cancer patients with highly suspected Mammotome biopsy, and the frozen section pathology of statistical accuracy, the treatment adopted in our hospital from December 2007 to January 2010 were recorded. All patients were followed up to now, with the average follow-up time of 28 months. Results Among 600 cases of Mammotome tumor resection in this study,patients cosmetic satisfaction with the skin incision 3 -4 mm, there were 9 cases （ 1.5 % ） of postoperative hematoma, 2 cases （0.14%） of residual tumor, with no other serious complications,the average time of excision was 15 min （5 - 30 min）, average blood loss was 3 mL;50 patients suspected of malignant patients had Mammotome biopsy, with the final paraffin pathology, diagnostic accuracy of frozen section 98% ;32 cases had the neoadjuvant chemotherapy;15 cases had the modified radical mastectomy ;2 cases of diffuse inflammatory lesions had anti-inflanmmtory treatment; 1 patient had neoadjuvant endocrine therapy;1 case of nature can not be confirmed. Condusion We concluded that the Mammotome excision had good cosmetic results, simple operation, less complications;Mammotome frozen section biopsy with high diagnostic accuracy rate can offer individualized breast cancer treatment options.