应用真空辅助活检系统进行乳腺多发病灶的诊断性切除

Application of vacuum-assisted breast biopsy system for the diagnostic excision of breast multifocal lesions

目的评价超声引导真空辅助活检(ultrasound-guided vacuum-assisted biopsy,UGVAB)系统对具有适应证的乳腺多发病灶和单发病灶诊断性切除的疗效。方法选择2012年3月至2014年2月期间的345例乳腺小病灶患者,在超声引导下通过UGVAB系统连接旋切刀穿刺到超声定位病变,尽可能完全切除病变。术后对诊断为良性病变的患者进行随访和超声检查。结果大多数患者在手术过程中有较好的顺应性。多灶性病变组不适症状发生率(18/157)高于单发病灶组(3/188),差异有统计学意义(P=0.000);所有病灶均获得准确的病理诊断,多灶性病变组中癌或ADH的发生率(14/157)高于单发病灶组(3/188),差异有统计学意义(P=0.004);多灶性病变组患者的术后并发症发生率及良性病变残留率均高于单发病变患者,差异均有统计学意义(P<0.05),发生术后并发症的良性肿瘤患者均不需进一步手术治疗。良性病变患者在术后6个月的复查中无假阴性。结论超声引导真空辅助活检系统对具有适应证的乳腺多灶性病变进行诊断性切除具有良好效果,值得在临床上推广应用。

Objective To compare and assess the value of ultrasound-guided vacuum-assisted biopsy system （UGVAB） in the diagnosis and excision of breast multifocal lesions and isolated lesions. Methods 345 patients were retrospectively analyzed and received ultrasound-guided diagnostic breast biopsy procedures performed by the 8-gauge vacuum-assisted biopsy approach from March 2012 to February 2014. All lesions were excised as completely as possible. One year and a half after operation, patients diagnosed as pathological benign lesions were followed up through physical and ultrasound examination. Results All lesions were obtained - rate pathological diagnosis. After 6 months of postoperative follow-up, all benign lesions did not appear apparent false-negative results. The rates of malignant or premalignant findings and postoperative complications were significantly higher in patients with multifocal lesions than in patients with single lesion （P 〈 0.05 ）. Postoperative complications in patients with benign tumors received no further surgery. Conclusions Ultrasound-guided vacuum-assisted biopsy system should be a routinely method of choice in diagnosing and treating breast multifocal lesions.