钼靶定位实时麦默通对乳腺钙化病灶的应用价值

Mammotome biopsy of breast calcified lesions under the real time guidance of mammography

目的探讨钼靶立体定位引导下实时麦默通对乳腺钙化病灶的临床应用价值。方法回顾性分析2011年1月至2012年2月重庆医科大学附属第一医院内分泌乳腺外科钼靶定位下实时麦默通诊治42例（2例含双侧病灶），快速石蜡病理检查明确。结果44个病灶中，良性病灶34个，其中乳腺病27个、纤维腺瘤2个、脂肪瘤1个、囊肿1个，其他良性病变3个，乳腺癌灶10个（1个诊断良性病变术后手术切除活检为乳腺癌）。42例中，良性病变占76．2％（32／42），乳腺癌占23．8％（10／42）。术中均显示病灶完整切除，若病检为恶性病变则行乳腺癌改良根治术、保乳术及化疗等综合治疗。单个病灶切除时间约20min。术后随访3个月未发现明显异常。结论钼靶立体定位引导麦默通实时对乳腺钙化灶的定性诊断，能检出临床考虑良性病灶的早期乳腺癌，早诊治可提高患者生活质量及延长生存时间。乳腺钼靶立体定位实时麦默通微创活检操作简便、定位准确、并发症少，是乳腺钙化病灶尤其是可疑恶性钙化病灶的首选方法。

Objective To discuss the value of mammotome biopsy of breast cakified lesions under the real time guidance of mammography. Methods The data of 42 patients with 44 mammary gland calcification（2 patients with bilateral lesions）who underwent mammotome biopsy under the real time guidance of a mammography from Jan. 2011 to Feb. 2012 in the First Affiliated Hospital of Chongqing Medical University were retrospective analyzed. Rapid paraffin pathology was conducted. Results Among the 44 lesions, 34 were benign（27 hyperplasia, 2 fibro- adenoma, 1 lipoma, 1 cyst, 3 others）and 10 were breast cancer（ a benign lesion diagnosed as breast cancer by post- operative biopsy was included）. Among the 42 patients, 32 patients had benign lesions, accounting for 76. 2% （32/ 42）, 10 patients had breast cancer, accounting for 23.8% （10/42）. All lesions were completely resected during the operation. Malignant lesions were given treatment such as modified radical mastectomy, breast conservation sur- gergery, chemotherapy and so on. A single lesion resection took about 20 minutes. During the follow-up of 3 months, no significant event happened. Conclusions Through the qualitative diagnosis of mammotome biopsy un- der the real time guidance of mammography, we can get early diagnosis of breast cancer. Early diagnosis and early treatment can improve the life quality and survival time. It is more important to detect early breast cancer which was considered benign lesions clinically. Mammotome biopsy under the real time guidance of mammography has several advantages including easy to operate, accurate positioning and less complications, making it the preferred approach in managing mammary gland calcification especially suspicious malignant calcification.