立体定位穿刺留置导丝引导手术活检隐匿性乳腺病灶

目的　评价立体定位穿刺留置导丝引导手术活检术对临床触诊阴性而乳腺X线摄影发现的隐匿性乳腺病变定位活检的价值。材料与方法　临床扪诊阴性 ,而乳腺X线片显示成簇的细小钙化、模糊小结节及局部结构紊乱等可疑的恶性病灶 ,通过计算机立体定位下穿刺 ,留置导丝于可疑的病灶区 ,然后手术取活体组织行病理学检查。结果　 31例患者 ,乳腺X线检查发现病灶34个 ,定位穿刺留置导丝 32根 ,导丝引导下手术活检 32例次均一次性成功定位与切除 ,定性诊断正确率为 10 0 %。病理检查结果 :恶性病变 9例次 11个病灶 ,良性病变 2 3例次。恶性病变中浸润性导管癌 4例次 5个病灶 ,导管内癌 3例次 ,乳腺单纯癌 2例次 3个病灶。结论　立体定位穿刺留置导丝引导手术活检术对乳腺隐匿性病变定位活检准确 ,既解决了外科医生术中对乳腺微小的病变定位的困难 ,又解决了盲目手术切除或针穿活检假阴性的问题。此技术创伤小 ,简单易行 ,是目前诊断早期乳腺癌的有效方法和技术保证

Surgical Biopsy of Latent Mammary Lesions with the Guidance of Indwelling Wire Placed in by Stereotactic Puncture

Objective To evaluate surgical biopsy with the guidance of indwelling wire placed through stereotactic puncture in diagnosing of non palpable and mammographically demonstrated small breast lesions. Materials and Methods Biopsy was done in patients with non palpable, mammographically suspected small lesions, which demonstrated malignant signs such as clusters of calcifications, poorly demarcated nodules or regional structural irregularities. After computerized stereotactic puncture of the lesion was done, a guide wire was indwelled in the suspected spot. With the guidance of the wire, surgical resection of the suspected tissue was made.Results Of 34 lesions found on mammograms in 31 patients, 32 were punctured with wire indwelling. Surgical biopsy, including localization and resection of the lesion, with the guidance of the wire was successful with only one procedure for all 32 lesions. The accuracy of qualitative diagnosis was 100%. Pathological results showed malignant in 11 lesions (9 patients) and benign in 23 lesions. Of 9 cases with malignancy, 4 were infiltrative ductal carcinoma (5 lesions), 3 intraductal carcinoma and 2 simple carcinoma (3 lesions). Conclusion Surgical biopsy with the guidance of indwelling wire placed through stereotactic puncture is very helpful in correctly localizing and removing small latent breast lesions. It can not only precisely locate the lesion for the surgeon, but also avoid false negative results due to blind resection or biopsy. The technique is less invasive and easy to perform, and is very helpful for the diagnosis of breast lesions.