Mammtome术诊断乳腺隐匿性病灶和不典型增生

Nonpalpable breast mass and atypical ductal hyperplasia-diagnosed by Mammotome biopsy and surgical management

目的探讨Mammtome术对乳腺隐匿性病灶的诊断,及对Mammotome术检出不典型增生的外科治疗策略.方法2003.3～2004.3月对该院14例共16处乳腺隐匿性病灶行超声引导下Mammotome微创旋切术,12例行起声引导下穿刺活检.结果Mammotome术检出14例16处乳腺隐匿性病灶中,5例非典型增生(31.3%),1例乳腺癌(6%);5例非典型增生中2例重度的和1例轻度的非典型增生接受手术,结果证实为重度的和轻度非典型增生,符合率100%.余2例中-轻度非典型增生未手术,给予他莫昔芬口服,随访无复发.12例行超声引导下穿刺活检中非典型增生1例(8.3%),再次手术结果为乳腺癌.结论Mammotome术利于乳腺隐匿性病灶的诊断.对Manmotome术检出不可触及肿块的重度非典型病灶,建议再次手术切除;对中度以下的非典型增生,在超声证实肿块已全切情况下,可避免再次手术,予他莫昔芬口服并随访.

Objective: Using the Mammotome biopsy technique, more accurate assessment of atypical ductal hyperplasia (ADH) is possible, specially by nonpalpable breast mass, making selective excision of these lesions a consideration. Methods: 14 women underwent 16 Mammotome core biopsies and 12 cases underwent core biopsies under B-us at Tongji Hospital from March 2003 to March 2004. Results: Of the 14 patients with 16 Mammotome core biopsies, 5 atypical(31.3%), and 1 adenocarcinoma(6%). Surgical excision in 3 patients with atypia on Mammotome biopsy showed atypia, too. Others do not excision and take Tamoxifen, following-up. Of the 12 cases underwent core biopsies under B-us 1 atypical (8.3%), Surgical excision showed adenocarcinoma. Conclusions: Serious ADH found on Mammotome, must undergo an operation. Mild ADH in nonpalpable breast mass (not associated with a personal or family history of breast cancer), may not need excision if all breast mass have been removed and take Tamoxifen, following-up. Breast lesions is more accurately diagnosed with Mammotome.