二维法乳腺不可触及病变钼靶X线引导钢丝定位手术切检的研究

Study on the Method of Two-dimensional Non Palpable Breast Lesions of Mammography Guided Wire Localization Biopsy of Surgery

目的:探讨钼靶X线引导下钢丝定位手术切检技术在乳腺不可触及病变(NPBL)的应用技巧和临床价值。方法:对64例钼靶X线片上NPBL患者,利用二维定位装置在X线引导下穿刺留置带钩钢丝,在钢丝引导下手术切检。切除标本X线摄影后行术中快速病理组织学检查,根据病理结果决定进一步手术或结束手术。结果:64例患者定位准确,手术完整切除病变。病理结果为良性病变50例,乳腺癌14例,其中导管原位癌7例,行保乳术3例,行乳房全切+前哨淋巴结活检4例,浸润性导管癌6例,行保乳术2例,改良根治术4例,髓样癌1例,行改良根治术。结论:合理的钢丝定位及切检技巧可提高切除病变的准确性,对乳腺X线发现的BI-RADS 4类及5类NPBL进行钢丝定位手术切检能明确病变性质、提高早期乳腺癌检出率。

Objective： To explore the mammography guided wire localization operation biopsy technique in non palpable breast lesions（NPBL） and the clinical value of the application of skills.Methods： 64 cases of molybdenum target X-ray on NPBL patients,using two-dimensional positioning device in X-ray guided percutaneous indwelling wire hook,surgical cutting biopsy in wire guide.With rapid histopathologic specimens were performed intraoperative radiographic examination,according to the pathological results of surgery or surgery decided to end.Results： 64 cases of patients with accurate positioning,complete resection of lesions.The pathological results of 50 cases of benign lesions,14 cases of breast cancer,including 7 cases of ductal carcinoma in situ,underwent breast conserving surgery for breast in 3 cases,total resection and sentinel lymph node biopsy in 4 cases,6 cases of infiltrating ductal carcinoma,breast conserving surgery in 2 cases,4 cases of modified radical mastectomy,1 cases of medullary carcinoma modified radical operation.Conclusion： Reasonable positioning and cutting wire inspection techniques can improve the accuracy of resection of the lesion,found the breast X-ray BI-RADS class 4 and 5 NPBL steel wire positioning operation biopsy can identify the nature of the lesion,improve the detection rate of early breast cancer.