乳腺肿块微创切除和(或)活检的新技术--Mammotome手术

目的介绍超声引导下使用Mammotome系统对乳腺肿块进行微创切除活检的实用性。方法在超声图像监控下，利用Mammotome系统对30例52个乳腺肿块进行切除活检．并记录术后随访情况。结果30例52个乳腺肿块被准确地完全切除，切除组织量大，足够用于病理诊断；46个肿块为纤维腺瘤，6个肿块为纤维腺病。术后4例并发血肿。切口小而隐蔽，乳房无变形。短期随访20例，肿块无残留和复发。结论Mammotome技术是一项切除准确、有效、安全、创伤小、并发症少的乳腺微创技术，可用于乳腺肿块活检．同时可对2cm以下的良性乳腺肿块进行切除。     

Mammotome乳腺肿块微创切除术的初步应用

目的探讨Mammotome真空微创穿刺活检系统在乳腺肿块进行微创切除活检术的应用价值。方法在超声图像的监控下,利用Mammotome系统特殊的真空抽吸系统和旋切系统对54例102个乳腺肿块进行肿块活检并将肿块切除。记录术后情况,对病例进行随访。结果54例102个乳腺肿块被准确地完全切除,切除组织量大,足够用于病理诊断,92个肿块为纤维腺瘤或纤维腺病伴腺瘤形成,10个肿块为纤维腺病。术后4例并发血肿。切口小而隐蔽,乳房无变形。短期随访47例无残留和复发。结论使用Mammotome微创切除术能够安全、准确地对2 cm以下的乳腺肿块进行切除活检,创伤小、并发症少,是治疗良性乳腺肿块尤其是无体征的乳腺肿块的一项理想的微创技术。     

超声引导下Mammotome旋切系统切除乳腺良性肿块的操作技巧

目的:探讨超声引导Mammotome微创旋切系统对乳腺良性肿块切除术的方法、并发症的防治及治疗价值。方法:回顾性分析162例374个乳腺良性肿块进行超声引导下Mammotome微创旋切手术的临床资料。结果:374个病灶均被B超引导下使用Mammotome旋切系统完全切除,每个肿块平均旋切次数为6次(3～31次),平均手术时间为12 min(5～25 min),术后仅留下0.3 cm的微小切口。手术无1例失败,成功率为100%。术后出现并发症10例(6.17%),保守治疗后均痊愈。病理结果:乳腺纤维腺瘤292个(78.07%),乳腺腺瘤6个(1.61%),乳腺腺病64个(17.11%),乳腺囊肿12个(3.21%)。结论:应用Mammotome旋切系统治疗乳腺良性肿块既能切除病灶得到组织学诊断,又能达到美学效果,可为治疗乳腺良性肿块(直径≤3.0 cm)的首选方法。     

高频超声引导下Mammotome微创旋切术在乳腺良性疾病中的应用

目的探讨高频超声引导下Mammotome微创旋切系统对乳腺良性疾病诊断和治疗的临床应用价值。方法分析高频超声引导下Mammotome微创旋切治疗40例64个临床诊断乳腺良性病灶的疗效，并记录术后病理结果及其随访情况。结果40例64个乳腺病灶被准确完全切除，切除组织足够用于病理诊断；其中35个病灶为纤维腺瘤，13个为乳腺腺病，11个为乳腺腺病伴纤维腺瘤形成，4个为乳腺囊肿，1个为导管上内乳头状瘤。1例术后出现局部血肿。结论Mammotome微创旋切术是一项创伤小、并发症少、安全有效的乳腺微创技术，对乳腺良性病灶能够进行完全切除。     

超声引导下Mammotome微创旋切系统在乳腺良性肿瘤治疗中的应用

目的 探讨超声引导下Mammotome微创旋切术在乳腺良性肿瘤中的诊治价值.方法 回顾性分析2006年10月至2009年3月我科238例乳腺肿瘤患者在高频超声引导下行Mammotome微创旋切术的临床资料,评价其在乳腺良性肿瘤治疗中的应用价值.结果 614个乳腺病灶绝大部分被切除,术后病理学诊断均为良性.术后血肿形成2例,皮下淤斑4例.术后6个月行超声复查,发现3例病灶残留.结论 超声引导下Mammotome微创旋切术是对直径小于2.5cm乳腺良性病灶的首选诊治方法,操作简单、安全,创伤小且病灶切除彻底.     

B超引导下Mammotome旋切系统在乳腺肿瘤中的应用：附115例报告

目的探讨超声引导下使用Mammotome(麦默通)系统对乳腺病灶进行微创切除及其活检的临床应用价值。方法在超声图像监控下,利用Mammotome系统对115例患者152个乳腺病灶进行切除或活检,并记录术后病理结果及随访情况。结果所有患者及所有乳腺病灶被准确完全切除并进行活检;其中86个病灶病理检查为纤维腺瘤,34个为乳腺腺病,2个为脂肪坏死,3个为男性乳房发育症,1个为导管炎症,26个为乳腺癌。活检病理与手术病理符合率100%。术后3例出现局部血肿,4例皮下瘀血,1例出现皮肤破损,无严重并发症。结论Mammotome技术是一项切除准确、有效、安全、创伤小、并发症少的乳腺微创技术,可对乳腺良性病灶进行切除,并可用于乳腺恶性肿瘤手术前活检。     

560例乳腺良性肿块Mammotome微创旋切术的临床应用

目的探讨B超引导下Mammotome微创旋切系统在乳腺良性肿块切除中的临床应用价值。方法在B超引导下应用Mammotome系统对560例病人896个乳房良性肿块施行微创旋切术。结果所有肿块均被准确、完全切除。每个肿块的切除时间平均为25min,旋切次数20次,皮肤切口0.2～.0.3cm无不良手术并发症发生。结论B超引导下Mammotome微创旋切系统切除乳房良性肿块,操作简易、准确、安全、创伤小,是一项值得推广的乳腺微创技术。     

超声引导下Mammotome微创旋切系统在乳腺肿瘤诊治中的应用

目的：探讨B超引导下Mammotome微创旋切系统对乳腺病灶的诊断价值，并探索其用于乳腺纤维腺瘤微创手术的可行性。方法：对289例430处乳腺病灶进行B超引导下Mammotome微创旋切术，通过病理检查与随访评价其对乳腺病灶的诊治效果。结果：Mammotome微创手术操作成功率达100％。皮肤伤口微小，仅3-5mm。无严重并发症。临床及超声诊断为乳腺纤维腺瘤者均在超声实时监控下完全予以切除。92例144处术后6个月。5年获得随访，其中89例141处经临床B超随访复查均未见“复发”迹象，肿瘤被完全切除率为97．9％（141／144）。对可疑病灶及Ⅲ期乳腺癌均取材满意，并能作出明确诊断。结论：B超引导下的Mammotome微创旋切系统对乳腺不同病灶均能作出明确诊断；对小纤维腺瘤成功进行微创切除术，创伤和皮肤伤口小，效果满意，对其他良性小病灶也可避免不必要的手术活检。     

超声引导下麦默通微创旋切术在乳腺手术中的应用研究(附1567例报告)

目的:探讨起声引导下麦默通( Mammotome)微创手术在乳腺外科中的应用价值,总结行超声引导下麦默通(Mammotome)微创手术的经验及注意事项.方法:从2010年3月至2012年4月本科室对1567例3761处乳腺病灶在超声引导下进行Mammotome微创旋切术,通过病理检查和随访,评价其在乳腺外科手术中的诊治效果,总结临床经验.结果:通过超声引导下麦默通( Mammotome)微创手术,拟行手术的肿物均可彻底切除.肿物长径为0.4～3.2cm,每个肿物平均切除时间为6min( 2～20 min),平均出血量为1ml,手术切口小,仅2～3mm.未发现手术严重并发症.其中99.55％患者术后病理回示为良性病变,另有原位癌2例,浸润性癌5例.术后对原位癌及浸润性癌的残腔周围及针道进行病理检查,针道均未见癌残留.结论:超声引导下Mammotome微创手术对乳腺肿块既可达到诊断和治疗目的,又有损伤小、操作简单、快捷、术后外观好的特点,同时提高乳腺肿块病理诊断率,更有利于临床触诊及辅助检查阴性的恶性肿瘤的早期发现.     

Mammotome乳腺良性肿块微创旋切术的临床应用

目的探讨B超引导下Mammotome微创旋切系统在乳腺良性肿块切除中的临床应用价值。方法B超引导下应用Mammotome系统对98例296处乳房良性肿块施行微创旋切术。结果所有肿块均被准确、完全切除。每个肿块的切除时间平均为25（15～60）min，平均旋切次数20（8～32）次，皮肤切口0.2～0.3cm。未出现活动性出血、皮下淤血、感染等并发症。结论B超引导下Mammotome微创旋切系统切除乳房良性肿块，操作简单、准确、安全、创伤小，是一项值得推广的乳腺微创技术。     

超声引导微创旋切术治疗乳腺肿瘤220例疗效分析

目的探讨超声引导下微创旋切系统在乳腺肿瘤诊断和治疗的临床应用及疗效分析。方法对两年多来经超声引导Mammotome微创旋切术治疗的乳腺肿瘤220例疗效进行回顾性分析。结果220例中共有病灶287个,所有乳腺病灶被准确完全切除,切除组织标本均行病理检查,术后1例局部复发、2例出现局部血肿。结论超声引导微创旋切术治疗乳腺肿瘤是一项创伤小、并发症少、安全有效的乳腺微创技术,对良性肿瘤能够完全切除。尤其受到年青女性患者的青睐。     

超声引导下Mammotome旋切系统在乳腺疾病诊治中的应用研究（附326例病例报告）

目的探讨超声引导下Mammotome旋切手术在乳腺疾病的诊断与治疗价值。方法我科2008年3月-2008年12月对326例患者406个乳腺病灶进行超声引导下Mammotome微创手术切除。对活检病理为良性的患者进行不少于8个月的随访;对于恶性或交界性病变的患者进行开放性手术：个别组织学和影像学特征不一致的患者进行开放性手术活检。结果术后病理学诊断恶性及良恶交接性病例共14例,均接受开放性手术。其中组织学低估1例（7．1％）,针道种植1例（11．1％）;312例共392个病灶为良性病变,其中假阴性1例;出现近期并发症5例（1．5％）,无患者出现远期并发症。结论超声引导下Mammotome旋切微创手术能完全切除5-30mm的乳腺病灶．具有较高的准确性和安全性。     

Mammotome biopsy under ultrasound conrol in the diagnostics and treatment of nodular breast lesions - own experience

Mammotome biopsy is an effective, minimally invasive, novel technique used in the verification of breast lesions.The aim of the study was to assess the value of ultrasound-guided vacuum-assisted core needle biopsy (mammotome biopsy) in the diagnostics and treatment of nodular breast lesions, considering own data.Material and methods. Analysis comprised 1183 mammotome biopsies under ultrasound control performed in 1177 female patients during the period between 2000 and 2010, at the Regional Clinic for Early Diagnostics and Treatment of Breast Lesions, I Chair and Department of General Surgery, Jagiellonian University, Collegium Medicum.Results. The average patient age amounted to 41.7 years. The size of the investigated lesions ranged between 4 and 65 mm (mean - 12 mm). The histopathological examination result was as follows: fibrocystic lesions (n=285), adenofibroma (n=477), adenosis sclerosans (n=188), hyperplasia without atypy (n=58), phyllode tumor (n=2), papilloma (n=14), hamartoma (n=1), atypical hyperplasia (n=25), in situ ductal carcinoma (n=4), in situ lobular carcinoma (n=5), infiltrating ductal carcinoma (n=114), infiltrating lobular carcinoma (n=4), non-diagnostic result (n=6). The histopathological diagnosis was obtained in 99.5% of cases. Patients diagnosed with atypical hyperplasia or cancer were qualified for surgery, according to accepted standards. The presence of a hematoma was the most common complication after the biopsy, observed in 16.5% of patients.Conclusions. The obtained results confirmed the high value of ultrasound-guided biopsies in the diagnostics of nodular breast lesions. The method is safe, minimally invasive, with few complications, providing a good cosmetic effect. In case of benign lesions with a diameter of less than 15 mm the mammotome biopsy enables to completely excise the lesions, being an alternative to open surgical biopsies. The mammotome biopsy should become the method of choice considering the diagnostics of nodular breast lesions.     

Mammotome乳房活检系统临床应用2794例报告

目的 探讨影像引导下Mammotome微创手术对乳腺病灶的诊断与治疗价值。方法 广东省人民医院肿瘤中心乳腺科2004年6月至2008年11月对2794例病人（乳腺影像学发现的BIRADS评级Ⅱ~V级病灶者）在影像引导下进行Mammotome微创活检术。 结果 术后病理学诊断乳腺浸润性癌263例,乳腺导管内癌240例,不典型增生53,良性病变2238例。263例乳腺浸润性癌接受外科手术及辅助治疗。240例乳腺导管内癌,53例不典型增生及99例乳头状癌接受外科开放性手术,3例被证实组织学低估。Mammotome微创活检术后活动性出血发生率为0.11%（3/2794）,血肿0.39%（11/2794）,无切口感染发生。所有病理诊断良性病变病人术后6个月始均接受B超随访。结论 应用影像引导下Mammotome旋切系统对乳腺病灶进行微创活检,获得明确病理组织学诊断,是一种有效的、安全的手术方法。     

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??Applied study on the minimally invasive surgery of breast for imaged-guided mammotome : a report of 2794 cases LIAO Ning, LI Xue-rui, MANG Kun, et al. Department of Breast Disease,Guangdong Provincial Pelple′Hospital,Guangzhou510080,China Corrsponding author??LIAO Ning,E-mail: drliao_ning@hotmail.com Abstract Objective To investigate the value of diagnosis and treatment in minimally invasive surgery of imaged guided mammotome for breast lesion. Methods From June 2004 to December 2008, 2794 cases underwent minimally invasive surgery under imaged guided mammotome. Results In postoperative pathological diagnosis , 263 cases was invasive breast cancer , 240 cases was ductal carcinoma in situ, 53 cases was atypical hyperplasia, 2238 cases was benign breast lesions. 263 cases of invasive breast cancer were given surgical treatment and adjuvant therapy. 240 cases of ductal carcinoma in situ, 53 cases of atypical hyperplasia and 99 cases of breast papillomatosis were given open surgical procedures. 3 cases were confirmed histologically underestimated. Incidence rate of postoperative active bleeding was 0.11% (3 / 2794), hematoma was 0.39% (11/2794), no incision infection. All patients of benign breast lesions were accepted follow-up by B-type ultrasonic inspection after 6 months. Conclusion Imaged- guided mammotome can perform the minimally invasive surgery for breasts lesion and a determinative histopathologic diagnosis can be obtained.     

Membranous fat necrosis of the breast: diagnosis by minimally invasive technique

Clinical and mammographic features of membranous fat necrosis (MFN) may simulate breast malignancy and tissue sampling is essential for accurate diagnosis. The aim of our study was to evaluate the clinical and imaging findings in these patients. Retrospective review of the records of breast biopsies (n = 1200) during the 5-year period 1998 to 2002 revealed eight (0.67%) cases of histologically proven MFN. Seven of the eight patients had a history of breast trauma or surgery. Seven patients underwent mammography: normal in two, a mass with curvilinear calcifications in one, and heterogeneous calcifications in four. Four patients underwent surgical excision of a palpable mass, one patient had complete excision of calcifications with large core biopsy technique, and three patients had stereotactic vacuum-assisted mammotome biopsy (VAMB). MFN should be included in the differential diagnosis of lesions in a breast with previous trauma or surgery. A minimally invasive diagnostic procedure should be considered in order to avoid excessive excisional surgery.     

乳腺良性病灶的微创手术

目的：探讨B超引导下Mammotome微创旋切系统对乳腺良性病灶的应用价值，及其与常规手术对比的优点。方法：将行B超引导下Mammotome微创旋切65例84处乳腺良性病灶与同期行常规门诊手术的482例535处乳腺良性病灶作对比，评价它们的诊治效果。结果：65例84处乳腺病灶均被Mammotome微创旋切术切除．平均旋切15次，用时26min；操作无一例失败。与常规门诊手术比较，这种方法皮肤伤口小，除6例有轻度皮下淤血外无其他并发症。结论：用B超引导下的Mammotome微创旋切术行乳腺纤维腺瘤微创切除，与常规门诊手术相比，其近、远期效果相同，但手术疤痕较小，减轻了病人的痛苦。