超声在早期触诊阴性乳腺癌术中定位的应用

目的：总结利用超声对早期乳腺癌行术中定位的应用与体会。方法：回顾性分析2002年1月～2010年1月我院57例临床触诊阴性的乳腺癌患者,行决定性手术之前利用术中超声对病灶进行定位,并用蓝染或金属导丝对病灶进行标记。结果：利用术中超声可正确地对乳腺癌病变进行定位切除,其中浸润癌占97%（55/57）,复切率为7%（4/57）,在所有患者中切缘阴性率为88%（50/57）,其中大部分切缘阳性的患者是无钙化的原位导管癌或浸润性导管癌伴广泛原位导管癌,只有5%的患者为多中心性浸润癌,并对其实施乳腺切除术。结论：对于临床触诊阴性的乳腺癌患者若需影像辅助术中定位病变时,超声应为首选方法之一。

Application of intraoperative positioning for the nonpalpable breast cancer by ultrasound in the early

Objective： To discuss the experience of localization for the nonpalpable breast cancer by ultrasound.Methods： 57 nonpalpable breast cancers were retrospectively analyzed between January 2002 and January 2010.Ultrasound localization was performed in the operating room immediately before definitive surgery.Breast cancers were localized by using either blue dye or a guide wire.Results： Ultrasound correctly localized all lesions at surgery.Negative margins for invasive carcinoma were found in 97%（55/57） of patients.Re-excisions were performed in only 7%（4/57） of patients.Overall negative margins were found in 88%（50/57） of patients.Most positive margins（70%） were due to the presence of noncalcified ductal carcinoma in situ.Mastectomy was necessary in 5% of patients,usually due to multifocal invasive carcinoma.Conclusion： Intraoperative ultrasound localization should be considered whenever a nonpalpable breast cancers needs image-guided excision.