立体定位导丝导向活检不能触及的乳腺病灶

Stereotactically guided wire localization biopsy for nonpalpable breast lesions

目的 探讨立体定位导丝导向活检不能触及的乳腺病灶的价值。方法 对 2 5例不能触及的乳腺病灶行立体定位导丝导向活检 2 6处 ,对每处病灶计算出穿刺针针尖至病灶中心的距离(D) ,并直接测量出留置的导丝头端至病灶中心的距离作对照。判断标准 :优 :D≤ 2 5mm ;良 :D =2 6～ 4 9mm ;差 :D≥ 5 0mm。结果 定位优 2 0例次 ,良 5例次 ,差 1例次。穿刺针针尖至病灶中心距离的计算值与直接测量值相符。 1次性病灶切除 2 6例次 ,标本体积的中位数为 10 5cm3,检出乳腺癌 6 (6 / 2 6 )处。结论 立体定位导丝导向活检不能触及的乳腺病灶能以最小的手术范围完整切除病灶 ,定位定性效果确切 ,可避免假阴性。提高了乳腺癌的早期检出率及诊断准确性。

Objective Through preliminary clinical use of stereotactically guided wire localization biopsy for nonpalpable breast lesions, we discussed the diagnostic accuracy of the technique and its value in early detection of breast carcinomas. Methods Stereotactically guided wire localization biopsy was performed on 26 lesions. The distance between the needle tip and disease center (D) was calculated and compared to that directly obtained from measurement of the localization between wire tip and center of the lesion. Localization was rated as excellent, good, and bad when D values were ≤2.5 mm, =2.6-4.9 mm, and ≥5.0 mm, respectively. Results Excellent, good, and bad localization results were achieved in 20, 5, and 1 procedures, respectively. These data correlated well with the direct measurements of the localization between wire tip and center of the lesion. Resection of 26 lesions on single operation was achieved and the median volume of the resected specimens was 10 5 cm 3. The breast carcinoma detection rate of 6/26 was achieved. Conclusion Our initial application of the technique showed that stereotactically guided wire localization biopsy for nonpalpable breast lesions was an effective tool for the localization and specification of breast lesions. It could avoid false negativity and help excise the entire lesion without excessive excision of the surrounding normal tissues. The technique was one of those that was worthy of more widely application for the preoperative diagnosis of nonpalpable breast lesions.