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钼靶下导丝定位活检在诊断触诊阴性乳腺病灶中的应用
作者:卫文俊  陶霖玉  齐柯  王玉蓉  曾凤好  黄银平  张好云  冯铎 
单位:广东医学院附属南山医院 甲状腺乳腺外科, 广东 深圳 518052
关键词:触诊阴性乳腺病变 钼靶X线摄影 导丝定位活检 乳腺癌早期诊断 
分类号:R604;R445.4
出版年·卷·期(页码):2013·32·第五期(559-562)
摘要:

目的:探讨钼靶下导丝定位活检技术对触诊阴性乳腺可疑病灶的诊断价值。方法:选取52例钼靶检查发现可疑病变而临床触诊阴性、彩超无特异发现的乳腺病灶进行钼靶下导丝定位后手术活检并送病理检查。结果:52例患者行钼靶引导下导丝定位均一次操作成功,术后病理报告:恶性病变16例,其中浸润性导管癌7例,导管原位癌6例,导管内癌早期浸润2例,浸润性小叶癌1例;良性病变36例,其中乳腺增生症15例,纤维腺瘤7例,轻~中度非典型增生5例,炎症性病变4例,导管内乳头状瘤3例,乳腺导管扩张症2例。乳腺癌检出率为30.8%,诊断准确率为100% 。结论:钼靶下导丝定位乳腺活检定位准确,安全可行,可有效提高不可触及的乳腺病变切除活检的精确性,利于早期乳腺癌的发现。

Objective: To explore the value of mammography-guided wire-localization biopsy in the diagnosis of nonpalpable breast lesion. Methods: Mammography-guided wire-localization biopsy and pathological examination were performed in 52 cases of breast suspicious lesions which were detected by mammography, but were nonpalpable in clinic and negative in B ultrasound. Results: All of 52 cases were successfully localized at first time. Sixteen cases of malignant lesions were detected, including 7 cases of infiltrating ductal carcinoma, 6 cases of ductal carcinoma in situ, 2 cases of intraductal carcinoma with early invasion, 1 cases of invasive lobular cancer; Thirty-six cases were diagnosed as benign lesions, including 15 cases of breast hyperplasia, 7 cases of fibroadenoma, 5 cases of mild to moderate atypical hyperplasia, 4 cases of inflammatory lesions, 3 cases of intraductal papilloma, 2 cases of mammary duct ectasia. The rate of breast cancer detected was 30.8%, and the diagnostic accuracy was 100%. Conclusion: Mammography-guided wire-localization biopsy is an accurate, safe and feasible method, which can effectively improve the accuracy of excision biopsy for non-palpable breast lesions, and promote to detect early breast cancer.

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