乳腺X线SNLB技术的定位定性

目的 探讨乳腺X线立体定位细针活检技术(SNLB)定位、定性诊断不可触及的乳腺病变。方法 对36例患者以SNLB进行定位及定性分析。结果 36例患者中，31例定位满意；其中。恶性病变16例。良性20例。结论 SNLB对不可触及的乳腺病变的定位、定性诊断有重要价值。     

X线立体定位倒钩钢丝置入引导切取活检乳腺隐匿病灶的探讨

目的探讨乳腺X线立体定位倒钩钢丝置入引导切取活检术(stereotacticmammographyneedlelocalizedbiopsy,SNLB)对乳腺隐匿病灶(nonpalpablebreastlesion,NPBL)的临床应用价值。方法回顾性分析37例行SNLB活检病例,所有病例均为临床触诊阴性,X线片上发现可疑改变但不能定性的病灶,将活检标本病理结果与X线表现进行对照。结果乳腺X线片上表现为细沙样簇状钙化18例;孤立的结节8例:局限性致密或结构紊乱7例;放射状毛刺影4例。SNLB活检组织标本病理结果中良性病变26例、恶性病变11例,其中包括导管原位癌4例。结论SNLB可准确诊断NPBL的性质,提高早期乳腺癌的检出率。     

不能扪及乳腺微小病变的术前钩丝定位研究

[目的]评价三维立体钩丝定位在诊断不可扪及乳腺微小病变(NPBL)中的应用价值.[方法]对70例钼靶摄片发现有可疑恶性病灶而临床触诊阴性的乳腺,运用三维立体定位系统行钩丝定位手术活检(SNLB)的病例进行回顾性分析.[结果]70例中,良性病变34例,恶性病变24例,非典型增生12例.定位过程中出现血管迷走神经反应9例.[结论]NPBL是SNLB的主要适应证,少数NPBL不适合这项检查,恰当选择病例是定位成功的先决条件.SNLB 是目前明确NPBL性质的一种简便、快捷、行之有效的方法.     

X线三维立体定位术诊断临床检查阴性乳腺病变

目的 探讨乳腺X线三维立体定位术在临床检查阴性乳腺病变中的诊断价值.方法 64例患者因乳腺X线摄影检查发现可疑病变而接受立体定位术.利用乳腺三维立体导丝定位术和三维立体定位穿刺术对乳腺不能扪及的病变进行术前定位和旋切活检,术后行病理学检查.结果 64例患者中,62例定位满意,2例定位偏离,定位满意度96.88%.其中恶性病变10例,7例为导管原位癌(DCIS),良性病变54例.结论 乳腺三维立体定位技术可发现和诊断临床检查阴性的乳腺病变,有助于提高乳腺DCIS的检出率.     

X线立体定位活检在乳腺微小病变的临床应用

目的　探讨应用乳腺摄片结合立体定位穿刺活检对不可触及的乳腺微小病变的诊断价值。方法　回顾性总结对 3 0例乳腺摄片发现微小病变的病人进行立体定位穿刺活检。结果　 3 0例病人中发现早期乳腺癌 9例 ,其中原位癌 3例 ,临床I期 6例 ,另外 ,乳腺纤维瘤 6例 ,不典型增生 9例 ,纤维腺病 4例 ,囊肿 2例 ,而乳腺癌、纤维瘤、不典型增生及囊肿均有明确的手术指征。结论　对不可触及的乳腺微小病变应积极活检 ,X线立体定位活检术是提高早期乳腺癌诊断率首选而有效的方法。     

钼靶X线立体定位留置钢丝活检对早期乳腺癌48例诊断分析

目的：探讨临床触诊阴性乳腺病灶的定位切除活检在乳腺癌早期诊断与治疗中的价值。方法：对48例患者行立体定位活检,并对活检组织进行病理检查。结果：48例触诊阴性的乳腺病灶一次定位活检成功,经病理检查证实恶性病变20例,良性病变28例。结论：X线引导下钢丝标记定位活检技术,解决了临床触诊阴性的乳腺病灶活检的精确定位问题,对于提高早期乳腺癌的诊断率有重要价值。     

钼靶X线导丝定位下乳腺活检的临床应用

目的 :对临床不能触及肿块的乳腺病变进行诊断。方法 :对 10例钼靶X线乳腺摄片显示有结节或恶性可能的簇状钙化灶而临床不能触及肿块的患者 ,手术活检前 2h在放射科钼靶X线引导下行乳腺细导丝定位 ,然后在局麻下行乳腺病变活检。结果 :10例采用此方法活检者均成功切取病变组织 ,病理结果为 :乳腺癌 3例 ,纤维腺瘤 3例 ,增生 2例 ,囊肿 1例 ,脂肪坏死 1例 ,无并发症发生。结论 :钼靶X线导丝定位下的乳腺活检 ,对不能触及肿块的乳腺病变可增加活检的准确性 ,是一种安全有效的诊断方法 ,对乳腺癌的早期诊断有一定意义     

铂靶X线导丝定位下乳腺活检的临床应用

目的：对临床不能触及肿块的乳腺病变进行诊断。方法：对10例相靶x线乳腺投片显示有结节或恶性可能的簇状钙化灶而临床不能触及肿块的患者，手术活检前2h在放射科相靶x线引导下行乳腺细导丝定位，然后在局麻下行乳腺病变活检。结果：10例采用此方法活检者均成功切取病变组织，病理结果为：乳腺癌3例，纤维腺瘤3例，增生2例，囊肿1例，脂肪坏死1例，无并发症发生。结论：钼靶x线导丝定位下的乳腺活检，对不能触及肿决的乳腺病变可增加活检的准确性，是一种安全有效的诊断方法，对乳腺癌的早期诊断有一定意义。     

X线引导下三维立体定位技术对乳腺疾病的诊断价值

乳腺钼靶X线摄影技术仍是目前乳腺检查的首选,尤其是早期乳腺癌诊断最有效的方法之一[1,2]。乳腺X线立体定位术能够准确定位、手术一次完成;乳腺穿刺活检能直接取得活体组织,进行病理诊断。本次研究旨在探讨X线引导下三维立体定位术的技术方法及在诊断临床乳腺微小病变中的价值。     

临床不能触及的乳腺肿块诊断与定位

目的探讨钼靶及B超对乳腺肿块的诊断与定位的临床意义.方法对68例临床不能触及的乳腺肿块进行钼靶摄片、B超引导下美兰定位,然后手术切除病灶,病理切片检查.结果手术时均能顺利找到病灶,并完整切除.B超及钼靶对良性病变的诊断符合率均为97%,对恶性病变诊断的符合率均为67%.结论临床不能触及的乳腺肿块其钼靶及B超的诊断符合率较高,在B超引导下着色法定位对基层医院是一种较好的定位方法.     

乳腺钼靶摄影对隐匿性乳腺病灶定位定性诊断分析

目的：评价乳腺钼靶摄影对隐匿性乳腺癌的诊断价值。方法：用美国Ｂｅｎｎｎｅｔｔ公司生产的乳腺钼甘摄像机及配套的定位仪对３０００例病人行双乳腺轴位,斜位摄片,依据影像表现对可颖病灶行定位穿刺活检。结果;对３２例隐匿性病灶进行定位穿检。查出乳癌８例。结论;乳腺钼靶摄像是目前诊断早期乳腺癌的有效方法,准确性高,简便易行。     

钼靶摄片立体定位穿刺乳腺活检的价值

目的 探讨钼靶摄片立体定位穿刺活检技术在早期乳腺癌诊断上价值。方法 对22例钼靶X片上乳腺有可疑病灶而无任何临床体征的患者,在X线定位下穿刺活检,明确诊断后采取不同手术方式治疗,手术病理对照。结果22例中8例（占36.4％）为乳腺癌,均行改良根治术;14例（占63.6％）为良性。空心针穿刺活检（CNB）与手术结果符合20例,诊断符合率90.9％。结论 X线钼靶摄片及定位穿刺活检可早期发现乳腺癌,提高诊断隐匿性乳腺癌的准确性,为外科制定手术方案提供依据。     

Sonographic evaluation of mammographically detected microcalcifications without a mass prior to stereotactic core needle biopsy

PURPOSE: The purpose of this prospective study was to evaluate the clinical usefulness of sonographically re-evaluating areas of microcalcification found mammographically before undertaking stereotactic core needle biopsy (SCNB). METHODS: Patients with nonpalpable breast lesions appearing as microcalcifications on mammograms and who had been referred to us for SCNB were re-evaluated sonographically before the procedure. None of the breast lesions had been associated with a density on the mammograms, and the initial sonographic evaluations had been negative. Using the mammograms for correlation, we meticulously re-evaluated the areas of microcalcifications sonographically using a high-frequency linear-array transducer. The sonographic and histopathologic results were then reviewed and correlated. The sonographic findings and visibility of the mammographically detected microcalcifications were analyzed by the 2-tailed Fisher's exact test and the chi-square test. RESULTS: Sixty-six patients, who had 68 cases of microcalcifications, were enrolled. Thirteen of the 66 patients underwent surgery, and 9 of the 13 were found to have breast carcinoma. In the sonographic re-evaluation before SCNB in these 9 patients, an associated soft tissue mass was demonstrated in 5 patients but not in the other 4. Sonographic re-evaluation also revealed abnormalities in 24 of 68 cases (35.3%), in contrast to the negative findings on the initial sonography. Using the chi-square test to identify a trend, we found that the percentage of cases that were sonographically visible was highest for clustered benign microcalcifications and lowest for segmental benign microcalcifications (p < 0.0001). CONCLUSIONS: In breast lesions that appear as microcalcifications without an associated mass on mammograms, pre-SCNB sonographic re-evaluation with a high-frequency transducer can depict microcalcifications, particularly the clustered ones, and can detect small associated masses. Although the absence of a sonographically detectable mass in areas of mammographically detected microcalcifications does not guarantee the absence of cancer, the presence of an associated mass on sonography should warrant close follow-up in the case of negative results to avoid a delay in the diagnosis of breast carcinoma.     

The role and efficacy of Mammotome biopsy (vacuum-assisted breast biopsy)

Mammotome (Vacuum-assisted Breast Biopsy System) is a device for needle biopsy of the breast which is useful for the biopsy of non-palpable lesions. Although Mammotome biopsy is performed on mammography or ultrasound guided, mammography -guided (stereotactic) Mammotome is more important because it is almost only devise for the biopsy of non-palpable microcalcifications. We performed 1000 cases of stereotactic Mammotome biopsy between February 2000 and February 2005 in Cancer Institute Hospital, 31% of the cases were diagnosed as cancer, among these cases 83% were noninvasive carcinoma and 17% were invasive. Of the cases which Mammotome revealed noninvasive carcinoma 17% were found to have invasive lesions after the operation. Mammotome is useful device for the diagnosis of early breast cancer.     

细针穿刺定位活检对诊断早期乳腺癌的意义

目的 探讨细针穿刺导丝定位活检(FNL)对诊断早期乳腺癌的意义。方法 28例临床触诊阴性、乳腺钼靶照相可疑病变的患者，根据轴位及侧位摄片显示的病灶位置，将穿刺细针穿入，并将导丝留置于病变内，随后外科医师沿留置的导丝将病灶切除，行病理检查。结果 5例病灶病理诊断为原位癌，1例浸润癌，阳性率为23．1％，患者行局部放射治疗，一年后未见转移及复发。1例轻度非典型增生伴导管内乳头状瘤，另6例为良性病变，14例为乳腺组织增生，1例穿刺失败。结论 细针穿刺定位活检不仅可以提高早期乳腺癌的诊断率，而且可以协助治疗。     

Fourteen-gauge ultrasonographically guided large-core needle biopsy of breast masses.

OBJECTIVE: Large-core needle biopsy of the breast can be performed with stereotactic or ultrasonographic guidance. However, ultrasonographically guided large-core needle biopsy has notable advantages, including the absence of ionizing radiation, increased patient comfort, and greater cost-effectiveness. The purpose of this study was to evaluate the accuracy of ultrasonographically guided large-core needle biopsy for the diagnosis of breast cancer in palpable and nonpalpable breast masses. METHODS: The study was a retrospective review of consecutive ultrasonographically guided large-core needle biopsies for indeterminate breast masses. A total 424 ultrasonographically guided core biopsies were performed in 367 patients with 1 or more breast masses. Ultrasonographically guided core biopsy was performed with a 14-gauge spring-loaded needle and a freehand technique. Correlation of ultrasonographically guided core biopsy pathologic findings with subsequent surgical pathologic findings or long-term imaging follow-up was performed. RESULTS: Of 424 indeterminate breast lesions for which histopathologic findings were obtained by ultrasonographically guided core biopsy, 234 cancers were diagnosed. Twenty-eight additional lesions had either questionable but not definitively malignant pathologic features (n = 11) or radiologic-pathologic discordance (n = 17) and were surgically excised. Of these, 8 additional cancers were diagnosed. Patients or surgeons chose excision of 41 additional lesions that were benign on ultrasonographically guided core biopsy No cancer was found in these surgical specimens. One additional cancer was diagnosed at a 6-month imaging follow-up because of interval growth. On the basis of surgical and long-term imaging follow-up, the sensitivity of ultrasonographically guided core biopsy for the diagnosis of breast carcinoma was 99.2% (95% confidence interval, 95.6%-99.9%) in 173 palpable breast masses and 93.2% (95% confidence interval, 87.1%-97%) in 251 nonpalpable masses. In cancers diagnosed on the basis of immediate surgical excision as a result of ultrasonographically guided core biopsy that showed either questionable pathologic features or radiologic-pathologic discordance, the sensitivity of ultrasonographically guided core biopsy for the diagnosis of breast cancer was 99.2%. CONCLUSIONS: Ultrasonographically guided large-core needle biopsy is a sensitive percutaneous biopsy method for the diagnosis of breast cancer in palpable and nonpalpable breast masses.