超声引导下麦默通旋切系统诊断不可触及乳腺病灶的临床研究

Applied study on the minimally invasive biopsy with Mammotome in the diagnosis of non-palpable small lesions of breast

目的探讨超声引导下麦默通旋切系统与BARD活检针在乳腺临床触诊阴性病灶活检诊断中的价值及意义。方法回顾性分析2010年8月~2013年6月220例乳腺X线摄影及彩超发现的临床触诊阴性乳腺病灶采用麦默通真空辅助旋切活检及BARD穿刺针活检术的临床资料。评价二者在乳腺病灶诊断和治疗中价值,分析其并发症的处理及预防。结果 172例麦默通活检患者及48例BARD穿刺活检患者,其活检成功率分别为100%及85.4%,病理符合率分别为99.9%及83.6%,两组比较差异有统计学意义（P〈0.05）。麦默通旋切组与BARD活检组发生出血、血肿、皮肤破损、皮下淤斑、病灶残留等并发症发生率分别为9.6%和35.4%,二者比较差异具有统计学意义（P〈0.05）。结论乳腺临床触诊阴性病灶进行超声引导麦默通旋切系统优于BARD活检针,具有微创、安全的特点,诊断灵敏度及特异度更高,病理符合率大,并发症轻,对早期乳腺癌的诊断具有重要的价值。

Objective To evaluate the application of Mammotome minimally invasive biopsy（ MMIBS） and BARD biopsy in diagnosis and treatment of non-palpable small lesions of breast.Methods Retrospective analysis was performed in patients with breast lesions obtained separately by Mammotome or BARD biopsy needle guided by ultrasound,and then analyzed by pathological examination,the cause for complications was analysed and the control strategy was studied. Results The success ratios of sample choosing for Mammotome and BARD biopsy needle were 100% and 85. 4%,respectively. The coincident ratios of pathological diagnosis of Mammotome and BARD biopsy were 99. 9% and 83. 6%,respectively. The incidence rate of complications（ subcutaneous hematoma,partial residual lesions,local hematoma） were 9. 6%and 35. 4% individually. There was significant difference between two groups（ P〈0. 05）.Conclusion MMIBS have gain an advantage,is characterized by producing minimal invasion,safety,high sensitivity and high specificity,and is recommended to be the first choice in the diagnosis of non-palpable small lesions.