超声引导下Mammotome微创旋切手术在乳腺不可触及病灶中的应用价值

目的探讨超声引导下Mammotome(MMT)手术在乳腺不可触及病灶(nonpalpable breast lesion,NPBL)中的应用价值。方法 2009年6月-2010年2月新疆医科大学附属中医院B超诊断NPBL 72例共148处,其中58例行高频X线检查未见肿块影及钙化,均行MMT手术及病理检查。结果 148处NPBL中纤维腺瘤69处(46.6%),纤维囊性乳腺病16处(10.8%),乳腺癌2处(1.4%),乳腺导管内乳头状瘤4处(2.7%),腺病52处(35.1%),肉芽肿性炎1处(0.7%),纤维囊肿病4处(2.7%)。良性乳腺病变70例(97.2%),经随访无复发及恶变,2例(2.8%)浸润性导管癌患者行改良根治术,无肿瘤残余,低估率为0。结论超声引导下MMT手术可以有效、微创、快速地确诊NPBL,是"一步手术"诊治的最佳选择,可降低早期乳腺癌漏诊的风险,减少低估,且术后美容效果满意。

Application value of Ultrasound-guided mammotome minimally invasive biopsy system in nonpalpable breast lesions

Objective To investigate the application value of ultrasound-guided mammotome minimally invasive biopsy system in nonpalpable breast lesions(NPBL).Methods Between June 2009 and February 2010,72 patients with NPBL(148 lesions) were diagnosed by ultrsonography received ultrasound-guided MMT biopsy in Affiliated Traditional Chinese medicine Hospital of Xinjiang Medical University.Among the patients,58 cases were diagnosed as having no breast mass or calcification,all patients were treated with MMT operation and pathological examination.Results In the 148 lesions,69 lesions(46.6%) were fibroadenomas,16 lesions(10.8%) were fibrocystic breast disease,2 lesions(1.4%) were intraductal papillomas,4 lesions(2.7%) were papillary intraduct carcinoma,52 lesions(35.1%) were adenosis,1 lesion(0.7%) was granulomatous mastitis,4 lesions(2.7%) were fibrocystic mastopathy,70 cases(97.2%) were benign without positive finding during follow-up.2 cases(2.8%) invasive ductal carcinoma patients were made modified radical operation without residual tumors,the underestimated rate was 0.Conclusion As an effective,minimally invasive,and rapid diagnostic technique for NPBL,ultrasound-guided MMT biopsy is an optimal tool for "one-step" operation.By this way,breast carcinoma underestimated risk can be decreased,moreover,these patients who received simple MMT operation were satisfied with cosmetic outcome.