B超在乳腺疾病诊断中的价值分析

目的：探讨B超在乳腺疾病诊断中的应用价值。方法：对70例怀疑为乳腺占位疾病的患者分别采用B超和钼靶X线检查,将检查结果与病理检查结果作对比分析。结果：使用B超对乳腺纤维瘤和乳腺囊肿诊断的准确率高于钼靶x线（均P〈0．05）;乳腺增生、乳腺癌的诊断准确率两组间无明显差异（P〉0．05）。结论：B超诊断乳腺疾病准确率高,且对人体无放射伤害,具有较高的临床应用价值。     

乳腺X线摄影对乳腺癌的诊断分析

目的：探讨乳腺X线摄影对乳腺癌的诊断作用。方法：回顾性分析27例乳腺癌患者，均行乳腺X线摄影且诊断为乳腺癌，后经手术病理证实。结果：27例乳腺癌患者通过行乳腺X线摄影，手术病理其中25例（92．6％）病理类型为浸润性导管癌，17例（63％）有同侧腋窝淋巴结转移。结论：乳腺X线摄影对乳腺癌的诊断有重要作用。     

乳腺疾病筛查中的超声应用

目的：探讨超声在筛查乳腺疾病中的临床应用及诊断价值。方法：回顾性分析2009年4月至2012年11月在我所进行乳腺疾病筛查的153名妇女的临床资料。结果：153位筛查者中,乳腺癌者3例,乳腺病变良性者15（1例。良性病变中,87例为乳腺小叶增生者,30例为乳腺囊肿,23例为乳腺增生结节,1（1例为乳腺纤维瘤。其中,有2例乳腺癌患者误诊为乳腺增生结节,术后经过病理学检查确诊为乳腺癌,超声诊断的正确率为98．7％。结论：根据乳腺疾病的各种超声特点结合,临床症状进行综合分析,超声对乳腺疾病具有诊断价值,可以避免不必要的手术,超声对于乳腺疾病有筛查作用。     

更年期女性乳腺增生患者激素水平特点

目的：探讨更年期女性激素水平变化对乳腺增生的影响。方法：回顾分析20例年轻女性雌二醇、雌三醇、雌酮和孕激素的化验结果，与20例更年期女性、患有乳腺增生的女性相应激素水平对比，发现更年期女性雌二醇相对增高。结果：更年期女性雌二醇相对过剩，雌三醇、雌酮和孕激素不足，导致了女性乳腺增生加重。结论：更年期女性雌二醇相对过剩，会造成乳腺组织过度增生。     

自拟纯中药养血疏肝散结汤治疗肝郁气滞型乳腺增生的疗效观察

目的：观察自拟纯中药治疗乳腺增生的临床疗效。方法：自拟养血疏肝散结汤治疗肝郁气滞型乳腺增生为基本方,辩证加减。结果：141例乳腺增生患者,痊愈27,显效61例,有效48例,无效5例,总有效率96.45%。结论：自拟养血疏肝散结汤治疗肝郁气滞型乳腺增生临床疗效满意,复发率低,无副作用,值得临床推广应用。     

应用高频彩超对女性乳腺健康普查的价值

目的：探讨高频彩超在女性乳腺健康普查中的应用价值。方法：对2013年1月至2013年6月在我科就诊及健康体检的500名妇女的乳腺彩超结果进行回顾性分析。结果：在500名受检者中，超声提示乳腺增生320例，乳腺囊肿20例，急性乳腺炎2例，乳腺实质性病灶62例，其中乳腺纤维瘤32例，乳腺癌8例。结论：高频彩超对女性乳腺进行健康普查具有很高的应用价值，是女性乳腺疾病普查的首选方法。     

2320型多功能治疗仪治疗乳腺增生症50例疗效观察

我院乳腺科近1年来应用2320型多功能治疗仪对50例不同程度乳腺增生症患者进行治疗和观察，认为该光电治疗仪对乳腺小叶增生、乳腺炎、良性肿块、乳痛等多种乳腺疾病均有显著的疗效。现将治疗结果报告如下。     

天冬合剂治疗乳腺增生病250例的临床研究

乳腺增生病是妇女乳房疾病的常见病和多发病。我院自1998年6月～2003年12月，应用本院制剂天冬合剂治疗3000多例乳腺增生病患者，并对其中的250例进行追踪观察，现报告如下。     

12391例妇女乳腺检查结果与分析

目的：楚雄城区妇女乳腺癌的发病率。方法：楚雄城区35～69岁妇女12391人全部接受乳腺临床体检和乳腺红外线扫描初筛检查,阳性者进一步做钼靶X线检查及乳腺彩色超声波检查,阳性者最后进行病理诊断。结果：检出乳腺癌患者5例,占40．35／107Y;纤维瘤4例,占20．38／10万。结论：楚雄地区的乳腺癌发病率接近我国发达城市发病率,因此开展早期发现、早期诊断、早期治疗工作势在必行。     

彩色多普勒超声介入乳腺疾病诊断的临床观察

目的：分析彩色多普勒超声介入乳腺疾病诊断的临床效果。方法：采用彩色多普勒超声进行对乳腺增生、乳腺炎、乳腺纤维瘤、乳腺囊肿和乳腺癌进行诊断,分析在人群中的病发率。结果：88例患有乳腺疾病患者中,乳腺增生有57例（64.7%）,乳腺炎15例（17.0%）,乳腺纤维瘤7例（7.9%）,乳腺囊肿6例（6.8%）,乳腺癌3例（3.4%）。乳腺增生的发生率显著高于其他四种类型（P〈0.05）,乳腺炎和乳腺囊肿的发生率无显著性差异（P〉0.05）,乳腺纤维瘤和乳腺癌的发生率无显著性差异（P〉0.05）。结论：彩色多普勒超声可应用于诊断和区分不同类型的乳腺疾病,具有很大的临床应用价值。     

Stereotactic needle breast biopsy: a review of current status and practice

The early detection of breast cancer is a concern to women and their physicians. Although screening mammography can identify early breast lesions, many are small and non-palpable. In the past, open excisional biopsy often was required to establish the diagnosis. Recently, stereotactic breast biopsy, a minimally invasive technique, has permitted tissue diagnosis of small lesions without open surgery, with results comparable to those obtainable with excisional biopsy. We reviewed this technique, its application in identifying small breast lesions, and in diagnosing breast cancer in its early stages.     

Ultrasound-guided biopsy of non-palpable breast lesions: correlation with the results of fine-needle aspiration biopsy

PURPOSE: The purpose of this study was the clinical evaluation of ultrasound-guided biopsy in comparison with ultrasound-guided fine-needle aspiration biopsy of identical, non-palpable breast lesions. MATERIALS AND METHODS: From August 1997 until July 1998, 73 ultrasound-guided biopsies were performed in 66 patients with non-palpable lesions of the breast. In 18 patients (age 33-77 years) with 20 non-palpable lesions, fine-needle aspiration biopsy (20-G needle) and biopsy (18-G biopsy needle) were performed on a single occasion. This was the patient selection of our retrospective study. RESULTS: One malignant neoplasm was found among the 20 biopsied lesions, while the remaining 19 lesions were of a benign nature. In 20% of the cases, the material obtained by fine-needle biopsy was not sufficient for a cytologic diagnosis, while biopsy allowed a diagnosis in 19/20 cases. No complications were observed. CONCLUSIONS: Ultrasound-guided biopsy using an 18-G needle is a suitable method for the evaluation of non-palpable lesions that are only visible on ultrasound. It represents an attractive alternative to fine-needle aspiration in the absence of experienced cytologic diagnosticians.     

Non-palpable breast lesions: radio-pathologic correlations on open excisional biopsies. Significance of the choice of technique for minimal excisional biopsy

OBJECTIVE: To decrease the number of open excisional breast biopsies, percutaneous breast biopsies have been developed to perform the histologic diagnosis of non-palpable breast lesions. Some techniques allow a complete removal of small radiologic lesions. To evaluate the accuracy of a pathologic analysis performed only on the radiologic findings, we studied the radiologic and histologic correlation on open excisional biopsy (OEB) specimens. The aim of our study was to determine how many carcinomas were found distant from the radiologic findings. MATERIAL AND METHODS: Non-palpable breast lesions have been excised after preoperative localization. The radiologic findings were classified in microcalcifications, masses, architectural distortion and in sonographic masses. The correlation between the radiologic and pathologic findings was studied and all the lesions incidentally discovered on histology with no correlation with the imaging findings or distant from the radiologic findings were described. One hundred and twenty-nine lesions have been evaluated in 99 patients. Radiologic findings included 79 clusters of microcalcifications, 30 masses, six architectural distortions and 14 sonographic lesions. RESULTS: The histopathological results were benign in 41.9%, malignant in 49.6% and atypical hyperplasia lesions were discovered in 8.5%. All benign lesions were correlated to radiologic findings. No malignant lesion was found at a distance. In three cases atypical hyperplasia lesions were coexistent with the radiologic findings correlated with benign lesions and in three cases they were found at a distance. All but two malignant lesions were correlated with radiologic findings. In two cases a microinvasive carcinoma and foci of labular carcinoma in situ were found coexistent with benign lesions. The subgroup of small lesions lesser than 10 mm included 31 benign lesions. A complete removal of these lesions should be obtained with percutaneous biopsies. CONCLUSION: A pathologic analysis targeted on radiologic findings is accurate. Numerous open excisional biopsies performed for benign pathology should be avoided.     

Large-core needle biopsy for diagnosis and treatment of breast lesions

Purpose: Large-core needle biopsy (LCNB) has become a more widely used technique in the evaluation of breast lesions. This study was undertaken to access the accuracy of percutaneous LCNB on breast lesions and the impact on further proceeding. Methods: A retrospective review of imaging-guided LCNB of 159 breast lesions was done. 143 LCNB were taken with ultrasound guided automated spring gun biopsy and 16 stereotactic-guided with vacuum-assisted biopsy device. Histology and morphobiological parameters were compared with subsequent material from surgery. Results: In 113 core biopsies (71%), an infiltrating breast cancer was diagnosed, 5 biopsies (3%) yielded in-situ/atypical lesions and a benign lesion was shown in 38 cases (24%). In 3 cases, insufficient/necrotic material was obtained. 108 patients underwent subsequent surgery. In 100/108 cases (93%), histology on LCNB and surgery was identical. LCNB was false negative in 5 core biopsies (5%). Immunhistochemical stains of hormone receptors, bcl-2, c-erbB-2, p53 and MIB-1 was comparable on LCNB and on surgical material. Based on the results of LCNB, 17/113 patients (15%) with infiltrating carcinoma were primarily treated with hormones or with neoadjuvant therapy. 32/38 patients (84%) with benign lesions were followed up by imaging control. Conclusions: In patients with benign lesions on imaging, open biopsies can be avoided by LCNB. In patients with biopsy proven carcinoma, therapy planning is improved.The addition of morphobiological parameters allows early individual treatment. Received: 29 May 2001 / Accepted: 20 August 2001     

Hand-held ultrasound-guided vacuum biopsy of mammary lesions--first experiences

OBJECTIVE: Evaluation of indications for ultrasound guided hand-held Mammotome-biopsy. MATERIAL AND METHODS: To achieve breast diagnosis 50 ultrasound guided hand-held Mammotome-biopsies were performed between January 3rd and April 4th, 2000. RESULTS: 34 patients presented with non-palpable, 16 with palpable breast lesions. The benign-to-malignant ratio was 80% to 20%. Complete removal of the lesion we established in 22 (44%) of all 50 procedures. Definitive breast diagnosis of malignancies was achieved in all but one case. CONCLUSIONS: We regard the ultrasound guided hand-held Mammotome-biopsy as diagnostic and surgical instrument that provides the clinician with a flexible and easy to use method of accurate breast diagnosis. Lesions too small, superficial, or deep for conventional core biopsy are indications for a ultrasound guided Mammotome-biopsy as well as abnormalities where wide sampling is considered important or small fibroadenomas. However, standard of care for breast diagnosis remains the conventional hand-held 14-gauge-core-biopsy. For malignant lesions hand held mammotomy must be regarded as a diagnostic and not a therapeutic procedure.     

Open surgical biopsy for nonpalpable breast lesions detected on screening mammography

The aim of this retrospective clinical study was the analysis of histologic findings of nonpalpable breast lesions managed by open surgical biopsy. A series of 630 women underwent 664 preoperative localizations of nonpalpable, mammographically detected breast lesions during the last 10-year period. Indications for biopsy were (1) clustered microcalcifications, (2) solid mass, and (3) radiologic parenchymal distortion. The lesions were localized preoperatively using hook-wire methods, and all biopsies were performed under general anesthesia. Histopathology revealed carcinoma in 172 (25.9%) cases; noninvasive in 114 (66.3%) cases and infiltrating in 58 (33.7%) cases. The highest malignancy rate was found in cases with microcalcifications (112 carcinomas out of 323 cases, 34.7%). Lymph node invasion was present in 25% of patients with invasive cancers. The hook-wire localization of nonpalpable breast lesions is a simple, accurate and safe method for detection of early breast cancers. Frozen section is feasible and accurate in the majority of these lesions, and therefore, diagnostic and therapeutic one-step surgical procedures could be performed.     

Breast cancer detection: experience in a suburban community

Six hundred sixty-nine breast biopsies performed at the Methodist Hospital of Southern California and the Arcadia Outpatient Surgery Center during 1987 and 1988 were reviewed. Three hundred twenty-eight biopsies were performed for clinical indications (lump, thickening, or nipple discharge). Three hundred forty-one biopsies (51%) were performed because of mammographic abnormalities and required preoperative x-ray localization. Of the 341 localized biopsy specimens, 261 were varieties of fibrocystic mastopathy, fibroadenoma, papilloma, or hyperplasia. An additional 31 cases showed atypical ductal or lobular hyperplasia. One hundred fifty-one breast cancers were detected in this series of 669 breast biopsies. One hundred two (68%) of these were detected as a result of a clinical finding, and 49 were detected as a result of mammographic abnormalities (a 32% incidence of occult breast cancers). Among the 341 x-ray localization biopsies performed, breast cancer was detected in 14%.     

Stereotaxic breast biopsy techniques have become the standard of care for mammographically suspicious lesions

An optimal technique for the evaluation of nonpalpable, suspicious mammographic lesions should have a low technical failure rate, no false-negative results and should remove the lesion completely. Since most of these lesions are benign, the procedure should be carried out in an outpatient setting without general anesthesia. Cancer is missed in 2.6% of cases with excisional biopsy following needle localization. Furthermore, 50-83% of these patients undergo a second surgical intervention for definitive surgical treatment. In contrast, the rate of missed cancers is less than 0.7% following stereotaxic core or large-core biopsies. However, using these techniques, discordant results and histologic high-risk lesions need to be recognized and reexcized. The cost-effectiveness of stereotaxic vacuum-assisted core biopsy has been demonstrated. Stereotaxic breast biopsy techniques such as vacuum-assisted core biopsy and large-core biopsy for suspicious mammographic lesions have low false-negative rates and result in few histologic underestimations.     

The role of preoperative hooked-wire localization of occult lesions for early detection of breast cancer

OBJECTIVES: Nonpalpable small lesions, usually few millimeters in diameter, consist an important problem in the early diagnostics of breast cancer. DESIGN: An aim of this paper was an evaluation of usefulness of preoperative hooked-wire localization of such lesions for the detection of breast cancer. MATERIALS AND METHODS: Material consisted of 131 patients aged 37-77 in whom 132 procedures of preoperative hooked-wire localization were performed. The correlation between the mammographic findings and the cytologic or histologic results were then evaluated, with the histologic results being treated as standard. RESULTS: Histologic examination of the localized lesions revealed benign changes in 71.2%, atypical ductal hyperplasia in 4.6% and cancer in 24.2%. Positive predictive value for mammography was 24%. Significant correlation was seen between the suspicion of cancer in mammography and the histologic results. CONCLUSIONS: Preoperative localization should be used as a method of choice in radial lesions, suspected clustered microcalcifications and after the positive result from SFAB.     

Mammographic wire localization in diagnosis and treatment of occult carcinoma of breast

The use of screening mammography has increased dramatically, leading to the discovery of suspicious, nonpalpable mammary lesions. Mammographic wire localization (MWL) is currently being used to facilitate the biopsy of these lesions. We reviewed 104 patients undergoing 106 biopsies after MWL during a 14 month period to determine the usefulness of MWL. The average age of the patients was 58 +/- 14 years, with a range of 38 to 83 years. Abnormal mammographic findings consisted of microcalcifications (48 per cent) or mass and density (43 per cent), or both (9 per cent). Lesions of the right side (55 per cent) and upper and outer quadrant (49 per cent) were predominant. An average of 1.4 (range of one to four) specimens taken at biopsy per patient were required to remove the lesion. The mean duration of the biopsy was 34 minutes, with a range of ten to 75 minutes, and the mean total time in the operating room was 63 (range 31 to 115) minutes. The average cost of the procedure did not differ significantly between local and general anesthesia ($1,030 versus $1,142, respectively). Pathologic findings included fibrocystic disease (77 per cent), carcinoma (12 per cent) and fibroadenoma (7 per cent). Normal mammary tissue was found in 4 per cent of the biopsies. Five of the 13 carcinomas were in situ and seven were either in situ (five) or microinvasive only (two); only six lesions were frankly invasive. Ten patients were treated with modified radical mastectomy while three had segmental resection. All patients had in situ or Stage I carcinoma. MWL effectively localized nonpalpable mammary lesions and allowed accurate diagnosis and treatment of early stage carcinoma of the breast.