Benign papillary neoplasms of the breast: mammographic findings

The clinical presentation, pathologic characteristics, and mammographic/ductographic (also known as galactographic) findings were reviewed in 77 patients with histologically proved benign papillary neoplasms of the breast. Patients were classified as having either solitary or multiple papillomas. Patients with multiple papillomas were further subclassified as having either central or peripheral papillomas. Fifty-one patients (66%) had solitary papillomas. Thirty-seven of these patients were symptomatic; 36 had spontaneous nipple discharge, and one had a palpable mass. Ductography was positive in 32 of the 35 patients who underwent the procedure. In the 14 asymptomatic patients, subareolar (n = 10) and peripheral (n = 4) mammographic abnormalities prompted biopsy. Fourteen patients (18%) had multiple peripheral papillomas, and one patient also had bilateral central solitary papillomas. Eleven of these patients were asymptomatic, while two presented with palpable abnormalities and one with spontaneous bilateral discharge. Mammographic findings included microcalcifications (n = 5) and clustering nodules (n = 2). Associated atypical ductal hyperplasia was found in six (43%) of the 14 patients with multiple peripheral papillomas. Some of these patients also had lobular carcinoma in situ and radical scars. Twelve patients had multiple central papillomas; all presented with spontaneous nipple discharge and had positive ductograms.     

Role of ultrasonography and MRI in the detection of wide intraductal component of invasive breast cancer--a prospective study

AIM: To compare the role of ultrasound (US) and magnetic resonance imaging (MRI) in the detection of extent and direction of intraductal components around invasive breast cancer in comparison with histopathological findings. MATERIALS AND METHODS: In 60 invasive breast cancers (59 patients), US features of the intraductal components were classified as: (a) solid ductal dilatation radiating from the tumour, (b) the presence of a satellite lesion in the same segment without ductal dilatation, (c) ductal dilatation between the main tumour and the satellite lesion. The criteria for the detection of intraductal components by MRI were as follows: (a) strand-like enhancement on the margin of the main tumour, (b) satellite lesions around the main tumour, or (c) bridging enhancement between the main tumour and the satellite lesion. The direction of the intraductal components was classified as towards the nipple and towards the periphery. RESULTS: Wide intraductal components (>or=15 mm) towards the nipple were proven histopathologically in 17 of 59 (28.8%) cancers, and wide intraductal components towards the periphery were proven histopathologically in three out of 60 (5.0%) cancers. One cancer was located too close to the nipple and it was not possible to measure the intraductal component towards the nipple. US and MRI could accurately detect wide intraductal components towards the nipple in 14 and 8 cancers, respectively, out of 17 cancers. Sensitivity, specificity and accuracy for detection of wide intraductal components towards the nipple by US were 87.5, 88.3, and 88.1%, respectively. Sensitivity, specificity and accuracy for detection of wide intraductal components towards the nipple by MRI were 50, 79.1, and 72.1%, respectively. When the results of both diagnostic methods namely US and MRI were combined, sensitivity rose to 93.7%, specificity was 72.1% and accuracy was 78.0%. CONCLUSION: Although ultrasound is more sensitive than MRI in the delineation of intraductal extension towards the nipple, there is no statistically significant difference in overall accuracy between the two modalities.     

溢液性乳腺癌的乳腺导管造影表现及病理基础

目的:分析溢液性乳腺癌的乳腺导管造影表现及其病理基础,为临床提供可靠的诊断依据,以提高早期乳腺癌的诊治水平。方法:临床表现为乳头溢液并经手术、病理证实的乳腺癌患者26例,回顾性观察其乳腺导管造影表现,并与病理结果对比分析。结果:26例中,导管原位癌8例;浸润性导管癌5例;导管原位癌伴早期浸润7例;复合型癌3例,其中导管原位癌合并浸润性小叶癌2例,浸润性导管癌合并浸润性小叶癌1例;导管内乳头状瘤病癌变3例,其中乳腺X线平片未发现异常5例,毛刺或分叶状肿块2例,肿块伴钙化9例,多形性钙化灶10例。乳腺导管造影主要表现:导管内充盈缺损伴有不同程度导管扩张;导管管壁浸润破坏对比剂渗漏,形成"潭湖征";导管管壁不规则,呈"虫蚀样"改变或"断续征"。本组乳腺导管造影诊断乳腺癌的符合率为88.4%。结论:乳腺导管造影是溢液性乳腺癌诊断的安全而有效的检查方法,具有很高的定性、定位诊断价值,尤其对临床触诊阴性的早期乳腺癌能作出较准确的诊断,提高了早期乳腺癌的检出率。     

Conventional galactography and MR contrast galactography for diagnosing nipple discharge: preliminary results

OBJECTIVE: We wanted to compare the clinical usefulness of conventional galactography and MR contrast galactography for diagnosing patients with nipple discharge. MATERIALS AND METHODS: Both conventional galactography and MR contrast galactography were performed prospectively in 16 patients. Gadopentate dimeglumine (0.1 ml) was mixed with non-ionic contrast medium (0.9 ml) to obtain a resultant volume of 1 ml and this was used for both examinations. Following conventional galactography, MR contrast galactography was performed after direct injection of contrast media into the duct. RESULTS: Conventional galactography and MR contrast galactography were concordant in 13 (81%) of 16 patients; the results were normal in five, ductal dilatation was noted in four and intraductal filling defects were noted in four. The remaining three (19%) patients demonstrated discordant findings on the two examinations. While conventional galactography revealed filling defects, the MR contrast galactography results were normal in two patients. The third patient had kinks-stricture on conventional galactography and MR contrast galactography showed ductal dilatation. This suggested there were false positive results for the three patients' conventional galactography, and all the three patients with discordant results underwent surgery and the histopathologic evaluation showed fibrocystic changes. CONCLUSION: MR contrast galactography may be used as an alternative imaging modality for making the diagnosis of pathologic nipple discharge. However, statistically supported studies with large pools of subjects for comparing the galactography and MR contrast galactography results are needed to confirm our findings.     

Diagnosis of papillomas of the breast: value of magnetic resonance mammography in comparison with galactography

The aim of this study was evaluation of MRI alone and in combination with mammography and galactography in the diagnosis of intraductal papillomas. From 1994 to 1998, a total of 48 women presenting with pathologic mammary secretion underwent galactography and magnetic resonance mammography (MRM). Thirty-five patients aged 16–71 years (average age 46 years) subsequently underwent surgery or diagnostic puncture and the histologic findings were compared with the results of the radiologic examination. Histology revealed papillomas in 16 cases. In 6 of these patients, there was associated malignant degeneration. Malignancy without associated papilloma was observed in 3 cases. Galactography displayed a sensitivity of 94 % and a specificity of 79 % with five false-positive findings and one false-negative finding in the recognition of intraductal papillomas. Malignant processes were detected by mammography/galactography in only one instance. Magnetic resonance mammography visualized pathologic contrast medium uptake in 8 of 9 cases of malignant disease (sensitivity 89 %). One patient with in situ ductal carcinoma escaped detection with MRM. Papillomas showed no or below-the-threshold-lying contrast uptakes with no specific sign suggestive of papilloma. Galactography in combination with mammography remains the primary diagnostic procedure in cases of pathologic mammary secretion or suspected papilloma. The addition of MRI permits exclusion of malignant disease with a high degree of certainty; thus, expectant management in individual cases with negative findings appears justified. Received: 18 November 1999; Revised: 20 March 2000; Accepted: 25 April 2000     

伴乳头溢液乳腺癌的乳腺导管造影表现与病理对照研究

目的:分析伴有乳头溢液乳腺癌的乳腺导管造影表现,并分析其病理基础,以提高诊断水平。方法:临床表现有乳头溢液并经手术、病理证实的乳腺癌23例,回顾性分析其乳腺导管造影的影像表现,并与手术病理结果进行对比分析。结果:23例中原位癌8例,浸润性导管癌10例(包括单纯癌6例、乳头状癌4例),导管癌早期浸润3例,乳头状瘤病恶变2例。病理上诊断早期癌13例(56.5%),其中8例临床未触及乳腺肿块。乳腺导管造影主要表现:导管内充盈缺损并伴有不同程度的导管扩张12例;乳腺肿瘤侵蚀导管形成潭湖征5例;溢液导管受乳腺肿块推挤,导管变形3例;导管持续显影、管壁不规则伴广泛微钙化灶1例。本组中乳腺导管造影诊断乳腺癌的符合率为82.6%。结论:乳腺导管造影对伴有乳头溢液乳腺癌的检出是一项安全、有效的检查方法,能准确观察到肿块与溢液导管的位置关系、溢液导管受侵蚀程度,而且还能检测出临床触诊阴性的早期乳腺癌。     

乳导管内视镜检查309例临床影像资料分析

目的评价乳导管内视镜对乳腺导管内疾患的临床诊断价值。方法回顾性分析309例乳头溢液患者纤维乳导管内视镜检查的临床影像资料。结果309例乳头溢液患者中单侧乳头溢液者290例(93.85%),双乳发生溢液者19例(6.15%)。其中乳导管扩张并炎症208侧(63.41%),闭塞性乳导管炎6侧(1.83%),乳导管积乳并炎症2侧(0.61%),单发导管内乳头状瘤70侧(21.34%),多发导管内乳头状瘤23侧(7.02%),乳导管内癌5侧(1.52%),不能除外乳导管内肿瘤或需随访观察14侧(4.27%)。所有导管内单发或多发乳头状瘤、乳导管内癌病例均经手术与病理证实。结论乳导管纤维内视镜对乳导管内病变的诊断具有重要临床价值,对于导管内可疑乳癌可在导管镜指引下行病灶活检手术。     

乳腺单发乳头状瘤钼靶X线诊断（附42例报告）

目的：提高对乳腺单发乳头状瘤放射学诊断水平。材料与方法：作者回顾分析了４２例经病理证实的乳腺导管内单发乳头状瘤临床表现，钼靶平片及造影片表现。结果：３７例（８８％）有乳头分泌物。９５％（３５／３７）发生于中央大导管。２４％（１０／４２）平片有异常改变。造影表现：５４％（２０／３７）表现导管内充盈缺损，４１％（１５／３７）表现导管完全阻塞，４３％（１６／３７）有导管轻度扩张。结论：乳头溢液为导管内乳     

Ductography: how to and what if?

Ductography of the breast is an underused procedure that often helps define the cause of unilateral, single-pore, spontaneous nipple discharge. Since nipple discharge may be caused by benign tumors, such as papillomas, or by carcinoma, such as ductal carcinoma in situ, identification of intraductal abnormalities with ductography is important. Further, diagnostic ductography and preoperative ductography help guide accurate surgical intervention. Without prior ductography, central duct excision may not result in removal of the abnormal ductal tissue or may result in removal of only a portion of the abnormal ductal system, causing the extent of disease to be effectively understaged. Once fundamental ductographic principles are learned, the procedure is easy to perform. If extravasation occurs, ductography is rescheduled for 7-14 days later. Elimination of air bubbles from the cannula, syringe, and extension tubing is vital. When reflux occurs, radiologists must be aware of a possible tumor in the distal-most duct. When ductal ectasia or fibrocystic changes are the cause of the discharge, conservative follow-up may be considered. Diagnostic radiologists who learn the technique of ductography and include it in their evaluation of nipple discharge will improve their interdisciplinary approach to this important sign of breast cancer.     

溢液性乳腺病166例X线诊断

目的进一步提高溢液性乳腺病的X线诊断水平。方法回顾性分析经手术、病理证实,资料完整的166例溢液性乳腺病的乳腺导管造影表现。结果乳腺导管扩张症78例:导管扩张增粗、管壁光滑;导管扩张伴炎症2例:导管扩张、管壁毛糙,造影剂渗入间质;乳腺囊性小叶增生11例:末梢导管扩张呈囊状、管径粗细不均;导管内乳头状瘤49例:圆形、类圆形充盈缺损,导管呈“杯口状”中断,边缘光整;导管内乳头状癌、导管内癌26例:导管扩张后狭窄,导管中断呈“刀切样”平直,管腔僵硬,充盈缺损呈圆形菜花状或不规则状。肿瘤性病变75/166例,占45.1%;其中恶性病变26/75例,占15.7%。结论乳腺导管造影对溢液性乳腺病的诊断与鉴别诊断有重要价值。     

MR imaging in patients with nipple discharge: initial experience

PURPOSE: To investigate the potential of magnetic resonance (MR) imaging in patients with nipple discharge. MATERIALS AND METHODS: Between February 1992 and December 1998, 23 patients with nipple discharge underwent contrast material-enhanced MR imaging at 1.5 T. Mammographic findings were negative in 22 of 23 patients and revealed asymmetry in one patient. Galactography was attempted in two patients, with negative findings in one patient and no success in the other. Fifteen of 23 patients underwent excisional biopsy-seven of 15 with MR imaging-guided localization, and one of 15 with mammographic localization. Eight of 23 patients were followed up clinically (range, 7-24 months; mean, 20 months). RESULTS: In 11 of the 15 (73%) patients who underwent excisional biopsy, MR imaging findings correlated with histopathologic findings. MR imaging demonstrated four of six benign papillomas and one of two fibroadenomas as circumscribed, enhancing subareolar masses. Findings of one MR imaging examination were negative, and benign tissue was found at excisional biopsy. MR imaging findings were suspicious in six of the seven patients with excisional biopsy findings of malignancy (regional enhancement [n = 2], ductal enhancement [n = 2], peripherally enhancing mass [n = 1], and spiculated mass [n = 1]). In one of the seven patients, a benign-appearing intraductal mass was identified at MR imaging; excisional biopsy revealed a benign papilloma with an adjacent focus of DCIS. CONCLUSION: MR imaging can help identify both benign and malignant causes of nipple discharge. It potentially offers a noninvasive alternative to galactography.     

The diagnostic value of galactography in patients with nipple discharge

To evaluate preoperative galactographic findings in the differentiation between the benign and malignant lesions in patients presenting spontaneous nipple discharge without mass. Of the 215 patients who have undergone the galactography, 181 cases with abnormal galactography had surgery performed. All galactrograms were reviewed and galactographic findings were correlated to the pathological results to determine diagnostic differentiation. Of the 181 cases we operated on, 112 cases were macroscopically bloody, with 30 cases having cancers (26.8%). Fifty-four cases with serous discharge had seven cancer cases (13.0%). No cancer cases with other color discharge were found. Of the 37 cancer cases, 11 cases had lesions located in the main mammary ducts (lactiferous duct and the segmental duct) (29.7%) and 26 cases had lesions in the peripheral ducts (the subsegmental duct and its branches) (70.3%) (P<.05). Of 113 cases with benign proliferative ductal lesions, 88 cases were located in the main mammary duct (77.9%) and 25 cases in the peripheral mammary duct (22.1%) (P<.05). Otherwise, 29 cancer cases (82.9%) had ductal obstructions and 28 cancer cases (75.7%) had irregular intraductal defects that appeared in the galactograms, which is different from the 113 benign proliferative ductal lesion cases that had 88 cases (71.7%) with ductal dilatation and 90 cases (79.6%) with lobular or smooth intraductal defects (P<.05). These results showed that the cancer cases had a higher rate of locating in the peripheral duct, irregular intraductal duct defects, and ductal obstruction, and a lower rate associated with ductal dilatation or torsion. The galactographic findings were evaluated using the tumor location, types of intraductal defects, ductal obstruction, and dilatation. Preoperative diagnostic galactography is useful in differentiating between the benign or malignant lesions in patients with spontaneous nipple discharge.     

Clinically occult, noncalcified breast cancer: serial radiologic- pathologic correlation in 27 cases

A serial radiographic-pathologic correlation based on specimen radiography was performed on 27 consecutive, clinically occult, noncalcified breast cancers to determine the frequency of and correlation between appearances at mammography, pathologic diagnoses, and the features of the histologic margins. Twenty (74%) of the lesions were infiltrating ductal cancers, five (19%) were intraductal cancers, and two (7%) were medullary cancers. Forty-one percent of these malignancies contained microscopic calcifications. Lesions demonstrated at mammography in these 27 cases consisted of a well-defined round mass (n = 1); well-defined lobulated masses (n = 2); indistinct round, oval, or lobulated masses (n = 7); irregular or mixed lesions (n = 7); spiculated masses (n = 9); and architectural distortion (n = 1). Histologic margins of infiltrating and intraductal cancers, created by several types of tumor-fat interfaces and surrounding reactive fibrosis, correlated with these radiographic appearances. Serial specimen radiographic-pathologic correlation can improve our understanding of the appearance of early breast cancer at mammography.     

溢液性乳腺疾病导管造影X线征象与病理结果分析

目的:分析溢液性乳腺疾病的乳腺导管造影表现及病理基础,以提高其X线诊断水平。方法:回顾性分析216例溢液性乳腺疾病患者的导管造影及病理资料。结果:共有226支导管造影成功。无明显异常呈阴性表现者占7.5%(17/226);肿瘤性疾病占26.5%(60/226),包括导管内乳头状瘤、导管癌,其中以导管内乳头状瘤多见(22.0%);非肿瘤性疾病占59.7%(135/226),包括导管扩张、炎症及乳腺囊性增生,其中以炎症最多见(39.4%,89/226)。结论:乳腺导管造影对溢液性乳腺疾病的诊断与鉴别诊断有重要价值。     

The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography

ObjectiveThe optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings.Materials and MethodsFrom July 2003 to December 2018, 101 women (mean age, 46.3 ± 12.2 years; range, 23–75 years) with pathologic nipple discharge were evaluated using pre-ductography (initial) US, ductography, and post-ductography US. The imaging findings were reviewed retrospectively. The standard reference was surgery (70 patients) or > 2 years of follow-up with US (31 patients). The diagnostic performances of initial US, ductography, and post-ductography US for detecting malignancy were compared using the McNemar’s test or a generalized estimating equation.ResultsIn total, 47 papillomas, 30 other benign lesions, seven high-risk lesions, and 17 malignant lesions were identified as underlying causes of pathologic nipple discharge. Only eight of the 17 malignancies were detected on the initial US, while the remaining nine malignancies were detected by ductography. Among the nine malignancies detected by ductography, eight were detected on post-ductography US and could be localized for US-guided intervention. The sensitivities of ductography (94.1% [16/17]) and post-ductography US (94.1% [16/17]) were significantly higher than those of initial US (47.1% [8/17]; p = 0.027 and 0.013, respectively). The negative predictive value of post-ductography US (96.9% [31/32]) was significantly higher than that of the initial US (83.3% [45/54]; p = 0.006). Specificity was significantly higher for initial US than for ductography and post-ductography US (p = 0.001 for all).ConclusionThe combined use of ductography and US has a high sensitivity for detecting malignancy in patients with pathologic nipple discharge and negative mammography. Ductography findings enable lesion localization on second-look post-ductography US, thus facilitating the selection of optimal treatment plans.     

Sonographically-Guided 14-Gauge Core Needle Biopsy for Papillary Lesions of the Breast

Objective

We wanted to assess the need for surgical excising papillary lesions of the breast that were diagnosed upon sonographically guided 14-gauge core needle biopsy.

Materials and Methods

Sixty-nine women (age range: 25-74 years, mean age: 51.7 years) with 69 papillary lesions (4.9%) were diagnosed and followed after performing sonographically guided 14-gauge core needle biopsies. Surgical excision was performed for 44 (64%) of 69 papillary lesions, and 25 lesions were followed with imaging studies (range: 6-46 months, mean: 17.9 months). The histologic findings upon core biopsy were compared with the surgical, imaging and follow-up findings.

Results

Core needle biopsies of 69 lesions yielded tissue that was classified as benign for 43 lesions, atypical for 18 lesions and malignant for eight lesions. Of the 43 lesions that yielded benign papilloma upon core needle biopsy, one had intraductal papillary carcinoma found upon surgery. An immediate surgical biopsy was recommended for this lesion because of the imaging-histologic discordance. No additional carcinoma was found during the imaging follow-up. Surgical excision was performed for 17 atypical papillary lesions, and this revealed intraductal (n = 6) or invasive (n = 2) papillary carcinoma in 8 (47%) lesions. Of the seven intraductal papillary carcinomas, surgery revealed invasive papillary carcinoma in one (14%).

Conclusion

Our results suggest that papillary lesions of the breast that are diagnosed as benign upon sonographically guided 14-gauge core needle biopsy can be followed when the results are concordant with the imaging findings.     

伴有乳头溢液乳腺癌与导管内乳头状瘤的乳腺导管造影诊断

目的：总结分析伴有乳头溢液乳腺癌以及导管内乳头状瘤的乳腺导管造影X线表现,评价两者的诊断与鉴别诊断价值。方法：回顾性分析经手术和病理证实的23例乳腺癌和36例乳腺导管内乳头状瘤患者的乳腺导管造影检查影像资料。结果：乳腺癌导管造影主要表现为分支导管内不规则的充盈缺损伴导管壁破坏、导管阻塞中断、“潭湖征”等较为典型的征象;导管内乳头状瘤的导管造影主要表现为大导管内光整的充盈缺损,导管壁多无破坏,并伴有导管扩张以及导管扭曲。乳腺瘤与乳头状瘤在充盈缺损、导管壁破坏、导管完全中断、导管扩张以及“潭湖征”等x线征象上差异有统计学意义（P〈0．05）。乳腺导管造影诊断伴有乳头溢液乳腺癌和乳头状瘤的符合率分别为78．3％和80．1％。结论：不规则的充盈缺损伴导管壁破坏、导管阻塞中断、“潭湖征”等征象及发生部位上乳腺癌和乳腺导管内乳头状瘤两者各有特点,是诊断和鉴别诊断的重点。     

钼靶X线征象与不同类型乳腺癌关系的病理基础研究

目的:探讨不同类型乳腺癌的X线表现与其病理基础之间的关系。方法:经乳腺X线检查,手术、病理证实的乳腺癌36例,共36个病灶,包括浸润性导管癌26个,导管内癌及导管内癌伴微浸润7个,浸润性小叶癌2个,黏液腺癌伴浸润性导管癌1个。观察乳腺癌的X线表现,与病理分型对照。结果:①癌灶的X线表现有肿块者23个(63.9%),有钙化者18个(50%),有结构扭曲者3个(8.3%);②呈肿块表现的以浸润性导管癌为主,占87.9%;有钙化者易出现在导管内癌和浸润性导管癌中,分别占87.5%、42.3%,尤其单纯钙化多出现在导管内癌中(71.4%,5/7);结构扭曲可见于浸润性导管癌和导管内癌中,其它类型未见。结论:肿块、钙化和结构扭曲为乳腺癌的主要X线表现。浸润性导管癌占乳腺癌的大部分,除单纯钙化首先考虑导管内癌,其余征象均首先考虑浸润性导管癌;肿块改变尚要想到髓样癌和黏液腺癌的可能;结构扭曲也可出现在导管内癌中。     

Papillary lesions of the breast at percutaneous core-needle biopsy

PURPOSE: To retrospectively review the imaging and histologic findings in patients in whom a benign papillary lesion was diagnosed at core-needle breast biopsy. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board at each institution; patient consent was not required. The study was HIPAA compliant. The authors reviewed the findings from 42 patients (age range, 26-76 years; mean age, 54.3 years) with 43 benign papillary lesions diagnosed at core-needle biopsy. Thirty-six (84%) of the 43 lesions were surgically excised, and seven (16%) were followed up with long-term imaging. The authors assessed the radiographic findings, the histologic findings at core-needle biopsy, and the findings at subsequent surgical excision or imaging follow-up. Statistical analysis was performed on a per-patient basis and included the Blyth-Still-Casella procedure to construct exact 95% confidence intervals (CIs) and the Fisher exact test. RESULTS: At core-needle biopsy, lesions were diagnosed as papilloma (n = 29), sclerosing papilloma (n = 8), and benign papillary lesions not otherwise specified (n = 6). For the 36 lesions that were surgically excised, histologic follow-up showed no residual lesion in 10, intraductal papilloma in 14, intraductal papillomatosis in two, papilloma with adjacent foci of atypical ductal hyperplasia (ADH) in eight, and well-differentiated papillary ductal carcinoma in situ (DCIS) in two. Mammographic follow-up in the remaining seven lesions revealed stable calcifications in five (at 28-55 months) and no residual lesion in two (at 26-29 months). In nine of the 42 patients (21%), the diagnosis was upgraded to either ADH or DCIS (exact two-sided 95% CI = 11.4%, 36.4%). CONCLUSION: The results strongly suggest that papillary lesions diagnosed as benign at core-needle biopsy should be surgically excised because a substantial number of lesions were upgraded to ADH and DCIS at excision.     

数字化三维立体导丝定位穿刺技术在乳腺微小病灶中的应用

目的:探讨数字化三维立体导丝定位穿刺术对乳腺微小病灶的诊断价值。方法:回顾性分析临床触诊阴性而影像学表现异常的患者41例(乳腺微小病灶43处),41例均行乳腺数字化三维立体导丝定位穿刺切除并进行病理学检查。结果:43处微小病灶均定位成功,病变完全切除。病理检查:恶性病变8处,其中原位癌3处,浸润性导管癌Ⅰ～Ⅱ级3处,导管内癌伴早期浸润1处,浸润性导管癌伴腋下淋巴结转移1处;良性病变35处。结论:乳腺数字化三维立体导丝定位穿刺技术定位准确、损伤小、诊断符合率高,是治疗乳腺微小病变的重要手段,也是发现早期乳腺癌的重要方法。