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     

超声造影在乳腺囊实性复合肿块良恶性鉴别及活检决策中的作用

目的 探讨超声造影在鉴别乳腺囊实性复合肿块良恶性并是否行超声引导下活检指导中的应用。方法 回顾性研究2020年1月至2021年1月经超声诊断为乳腺囊实性复合肿块患者74例,结合病理及随访结果分析常规超声及超声造影声像图特征并对乳腺囊实性肿块恶性诊断效能进行评价;分别统计常规超声及超声造影后决定行组织穿刺活检的例数。结果 病理证实的60例患者中良性45例,恶性15例。超声造影乳腺囊实性复合肿块实性部分有无强化、强化范围是否增大及实性部分基底部突破特征对于区分肿块良、恶性差异有统计学意义(p<0.05)。超声造影可提高乳腺囊实性复合肿块恶性病变诊断的敏感性。超声造影后对乳腺囊实性肿块活检的决定被改变25.7%;而对于怀疑恶性乳腺囊实性复合肿块超声造影不会改变穿刺的决策。结论 超声造影在乳腺囊实性复合肿块的良恶性鉴别中有一定作用,为指导超声引导下乳腺穿刺活检决策提供新方法。     

高频彩超引导徒手粗针穿刺活检乳腺肿块的临床研究

病理学检查是乳腺肿块性质判断的金标准,因此术前获取病理学诊断十分重要.如何在创伤最小、并发症最少的前提下,获取准确的病理诊断一直为临床医生所关注.乳腺租针穿刺活检(CNB)是近年来发展起来的乳腺活检技术,主要应用于乳腺病变术前明确良恶性,指导手术方式.笔者对30例乳腺病变患者行彩超引导下穿刺活检,取得满意效果,现报告如下.     

第11例体检发现左乳腺肿块——手术病理诊断结果

超声体检后患者行左乳腺肿块切除术,术后病理诊断:(左乳腺)纤维囊性乳腺病,乳腺导管上皮不典型增生,有癌前病变倾向.……     

超声引导下粗针穿刺组织活检诊断乳腺肿瘤价值

目的观察超声引导下乳腺肿块穿刺活检的临床应用价值。方法77例拟诊乳腺癌患者,在超声引导下行粗针穿刺活检术,对取得组织行组织病理检查或免疫组织化学检查。结果患者均穿刺成功,取材满意度100％,穿刺后均未发生并发症,组织病理诊断恶性肿瘤72例,良性肿瘤5例。结论粗针穿刺组织活检操作简单、损伤小,是诊断乳腺肿块性质的有效方法之一。     

肉芽肿性乳腺炎八例诊治反思

目的探讨肉芽肿性乳腺炎的诊断及治疗方法。方法回顾性分析手术病理证实的8例肉芽肿性乳腺炎临床资料。结果 8例均为单侧发病,5例为乳腺实性肿块,3例局部皮肤红肿伴波动感。5例实性肿块行钼靶X线检查提示乳腺炎症、恶性肿瘤待排除,其中1例考虑炎性乳癌,行细针穿刺活检见大量炎细胞,1例怀疑乳腺结核查找抗酸杆菌、结核DNA阴性,均经手术切除治愈;3例局部皮肤红肿伴波动感,经彩超检查及细针穿刺检查考虑乳腺脓肿,行切开引流并抗感染治疗无效,行扩大切除术治愈。8例术后诊断肉芽肿性乳腺炎。结论肉芽肿性乳腺炎临床少见,彩超及钼靶X线检查可助诊,确诊需手术病理检查,病变部位应完整切除以避免复发。     

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。     

触诊引导乳腺肿块的穿刺组织学活检

目的探讨乳腺肿块触诊引导穿刺活检的准确性及可行性.方法对本组34例乳腺较大肿块(＞3 cm)患者采用18G活检枪手法触诊引导穿刺活检肿块组织芯,每部位取3针送病理,对较小肿块可增加穿刺次数,以提高阳性率.结果本组患者穿刺活检过程均顺利,成功率较高,良、恶性鉴别率达100%,基本达到了病理诊断目的,且无较重并发症发生.结论对于乳腺较大肿块(＞3 cm)可触诊引导,直接穿刺活检成功.     

超声引导下乳腺小肿块穿刺活检临床价值初步探讨

目的:探讨超声引导下粗针活检对乳腺小肿块的诊断价值。方法:采用Bard可调式自动活检枪,18G切割活检针,实时彩色超声监视,每个病灶取材2～3次。结果:132例患者共70例获手术病理,其中1例穿刺失败,病理证实乳腺癌18例、叶状囊肉瘤1例、良性病变50例,超声引导下粗针活检诊断小乳腺癌的特异度和灵敏度分别为100%和89.5%。结论:超声引导下粗针活检是一种特异度和灵敏度均较高的乳腺小肿块术前诊断方法。     

X线摄片和数字化电脑立体定位穿刺活检对早期乳腺癌的诊断（附70例分析）

目的：通过统计分析70例乳腺癌的高频X线影像表现,结合10例数字化电脑立体定位穿刺活检,提高对乳腺癌诊断的状况,尤其对早期乳腺 的诊断认识,方法：选取经手术,病理证实为乳腺癌的70例频X线摄影片（10例行数字化电脑立体定位穿刺）进行回顾性综合分析。结果：70例乳腺癌中,69例为原发,1例为继发。高频X线上表现为肿块影为58例,无肿块影仅为恶性钙化灶为7例,影像学表现为局限致密浸润,通过数字化电脑立体定位穿刺活检诊断5例。结论：高频X线摄影和数字化电脑立体定位穿刺对诊断乳腺癌具有重要价值。     

Ultrasound-guided biopsy of palpable breast masses

Objective: Breast ultrasound and US-guided interventional procedures of the breast are increasingly being applied and integrated in the diagnostic work-up and management of breast patients. The aim of the study was to assess the reliability of ultrasound-guided (US-guided) needle core biopsy of palpable breast masses with a 1.2 mm needle (18 gauge) in a fully automated firing device as an alternative to the existing surgical routine, i.e. surgical excision or palpation-guided Tru-Cut biopsy with a 2.0 mm needle (14 gauge) in a semi-automated device. Method: US-guided biopsy of palpable breast masses was prospectively, consecutively and openly compared to open surgical biopsy in a design closely connected to the routine diagnostic work-up of these patients. Results: 106 Patients with a palpable mass in one of their breasts were included in this study. The final diagnosis was the histological result of the open surgical biopsies, which were: 49 malignant lesions, 14 fibroadenomas, and 43 cases of fibrocystic disease. Forty-six malignant tumors were detectable ultrasonically and US-guided biopsy was performed, yielding adequate and correctly positive diagnoses in 41 cases (89%). Three US-guided samples were adequate for diagnosis but yielded a false-negative result. Two samples were excessively fragmented and thus inadequate for diagnosis. All 14 fibroadenomas were correctly diagnosed ultrasonically and US-guided sampling yielded a correct diagnosis in all but one case which was inadequate. The remaining 43 cases showed no abnormality on the sonogram and open biopsy yielded fibrocystic disease. Conclusion: US-guided biopsy of palpable breast masses can obviate open surgical biopsy whenever a mass is ultrasonically visible and it is strongly advocated to implement the procedure in the diagnostic work-up of these patients.     

超声引导穿刺活检对乳腺癌内乳淋巴结定性的诊断价值

目的:探讨超声引导经皮穿刺活检对乳腺癌内乳淋巴结定性的诊断价值。方法:对20例乳腺癌患者的肿大内乳淋巴结,在超声引导下行经皮穿刺活检。结果:穿刺活检成功率85.0%(17/20)。16例获得明确病理诊断,均发现癌细胞,诊断准确率94.1%(16/17),无严重并发症发生。结论:超声引导经皮穿刺乳腺癌肿大内乳淋巴结组织学活检是一种简便、安全、有效、诊断准确性较高的方法,能为临床诊断和治疗提供依据。     

超声引导下穿刺活检对乳腺癌诊断的价值

目的探讨超声引导下穿刺活检对乳腺癌的诊断价值。方法 对42例乳腺肿块患者超声引导下穿刺活检,与术后病理结果进行对比。结果42例均成功穿刺,术前穿刺活检诊断乳腺癌36例,经手术后病理证实其诊断符合率857％,假阴性率14．3％。结论超声引导下穿刺活捡创伤小、诊断准确率较高,是乳房肿块定性诊断的首选方法之一。     

高频超声引导下穿刺活检在小乳癌及乳腺癌前病变中的应用价值

目的 探讨高频超声引导下穿刺活检在小乳癌及乳腺癌前病变诊断和治疗中的临床价值.方法 对超声发现的92例乳腺小病灶,在高频超声引导下进行穿刺活检取得病理结果 ,并与手术后病理进行对照.结果 穿刺病理结果 为56例乳腺癌、7例乳腺癌前病变及29例乳腺良性病变,91例与手术后病理结果 相符,仅1例活检穿刺报告为腺病者手术后病理证实为导管内原位癌.超声引导下穿刺活检诊断乳腺癌和癌前病变的敏感性为100%,特异性为96.6%,准确性为98.9%.结论 高频超声引导下对乳腺小病灶进行穿刺活检是安全、可靠的术前早期诊断方法 .     

The mammary hamartoma: appreciation of additional imaging characteristics.

OBJECTIVE: To determine the mammographic and sonographic findings of hamartomas that were not classic on imaging, how pathologists distinguish the hamartoma from benign breast tissue on core samples, and reasons for discrepancies between core and surgical biopsy. METHODS: A retrospective review of all image-recommended core biopsies between 1993 and 2001 was performed. There were 41 cases of hamartomas found on either core or surgical biopsy. The mammographic, sonographic, and pathologic findings were reviewed. RESULTS: Of 41 hamartomas in 38 patients, 18 went on to surgical biopsy. Of these 18 cases, 4 cases of hamartoma on core biopsy were fibroadenoma after excision; 2 cases of hamartoma on core biopsy were confirmed by surgery; and 12 cases of fibrocystic change after core biopsy were hamartoma after surgical biopsy. The 4 cases of fibroadenoma shown at final pathologic examination were excluded from imaging review, leaving 37 cases. In the 20 patients who underwent only core sampling, 23 hamartomas were diagnosed. Seventeen masses were visible on mammography, and 82% were homogeneously dense. Of 36 masses shown on sonography, 86% were uniformly hypoechoic. At histologic examination, only 16% contained fat within the mass. CONCLUSIONS: Hamartomas may appear as homogeneously dense, well-circumscribed masses, varying in appearance from the classically described encapsulated mixed fatty-fibroglandular mass. Pathologists can make the diagnosis of hamartoma without the presence of adipose tissue but may have difficulty in distinguishing the hamartoma from fibrocystic change. However, if there is radiologic-pathologic concordance, further surgical excision is not warranted.     

超声引导下穿刺活检对乳腺癌前病变的诊断价值

目的 探讨超声引导下穿刺活检诊断乳腺癌前病变的准确性及提示病变可能被低估的超声表现。方法 收集经超声引导下穿刺活检的乳腺肿物患者605例,记录肿物的超声表现,将穿刺病理结果与术后病理或随访结果进行对比。结果 除3例患者因组织过少未获得穿刺病理诊断外,602例患者的穿刺病理与术后病理或随访结果对比,符合率为97.84%（589/602）,两者间一致性较好（Kappa=0.96,P=0.01）。穿刺活检结果为癌前病变者与术后病理或随访结果对比符合组32例,低估组10例,低估率为23.81%（10/42）。符合组和低估组癌前病变的钙化、后方回声衰减、血流、可疑淋巴结在两组间差异有统计学意义（P均<0.05）。结论 超声引导下穿刺活检对诊断乳腺肿物的准确率较高,但对癌前病变存在一定低估,尤其对于超声表现有恶性特征的癌前病变应考虑低估的可能。     

彩色超声引导下乳腺肿块穿刺活检的临床价值研究

目的探讨彩色超声引导下乳腺肿块穿刺活检的临床价值。方法采用Bard可调式自动活检枪，16G切割活检针，实时彩色超声监视，每个病灶取材2～4次。结果105例乳腺实性占位性病变，共112个病灶，80例获手术病理，怀疑恶性2例，不符1例，假阴性2例，诊断敏感性95．2％（100／105），诊断准确率达97．1％（102／105）。结论彩色超声引导下对乳腺病变进行穿刺活检，与手术切除病理诊断有很强的一致性，且副作用少，简单安全，成本低，容易被患者接受，值得临床推广使用。     

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.     

超声引导下乳腺小病变的活检

目的评估实时超声引导下穿刺活检对乳腺小病变良恶性的鉴别诊断价值。方法21例乳腺小病变均经高频超声与彩色多普勒超声检查,并根据二维声像特征按Stasrov分类法将乳腺小病变分成恶性组(5例)、性质未定组(13例)及良性组(3例)。所有病例均在实时超声引导下行乳腺活检取得病理诊断。结果高频彩超诊断为恶性可能组的5例中,3例活检病理证实为恶性肿瘤,2例活检病理为良性,误诊率为40%;高频彩超诊断为性质未定组13例中除1例活检病理证实为恶性外,其余12例活检病理均为良性。高频彩超诊断为良性组3例,活检病理均为良性。21例中有7例乳腺病变作手术切除,术后病理与穿刺病理相一致。结论实时超声引导下行乳腺小病变穿刺活检,可以进一步提高早期乳腺癌的确诊率,是一种理想的术前诊断方法之一。     

乳腺导管造影诊断乳头溢液疾病98例分析

目的探讨乳腺导管造影对乳头溢液疾病的诊断价值,提高诊断和鉴别诊断水平。方法回顾性分析经临床和手术病理证实的98例乳头溢液患者的乳腺导管造影片的X射线资料。结果乳腺导管造影正常者8例,占8.16%;导管内乳头状瘤32例,占32.65%;单纯导管扩张46例,占46.95%;纤维囊性乳腺病及乳腺增生7例,占7.14%;导管扩张伴炎症3例,占3.06%;导管癌2例,占2.04%。结论乳腺导管造影对诊断和鉴别诊断乳头溢液疾病有很重要的价值,可为临床提供可靠的诊断治疗依据。