乳腺钙化灶全数字X线立体定位活检不同术式的比较研究

目的:对目前乳腺X线立体定位下常用的两种活检方法进行评价。方法:对行乳腺钙化灶治疗的乳腺癌患者334例中接受立体定位真空辅助旋切活检(SVABB)手术243例,导丝定位开放活检手术91例,通过随访比较两种方式乳腺钙化灶活检情况。结果:SVABB活检方法在组织学低估率低于开放手术活检(P<0.05);乳腺SVABB与手术活检BI-RADS分类中IV(5.59%vs 4.92%)、IVb(27.45%vs 21.74%)、IVc(58.35%vs 42.86%)差异均有统计学意义(P<0.05);两种活检方式在操作时间、术中出血量、住院时间、医疗费用、疤痕大小、乳房皮肤凹陷、乳头移位及术后血肿比较差异有统计学意义(P<0.05)。结论:SVABB是一种准确、安全、简便的诊断方法,可作为乳腺钙化灶诊断的首选方法,扩大普及力度。

Comparative study on different methods of full digital X-ray stereoscopic localized biopsy for breast calcification

Objective:To evaluate two methods of breast X-ray stereoscopic localized biopsy.Methods:A total of 344 patients with breast cancer who underwent treatment for breast calcification were selected,and 243 patients received stereotactic vacuum assisted breast biopsy(SVABB),91 patients received guide wire positioning open biopsy surgery;the biopsy conditions of breast calcification of two methods were compared by follow-up.Results:The histologically underestimate rate of SVABB biopsy method was statistically lower than that of open surgical biopsy method(P<0.05);the proportions of stage IV,stage IVb,and stage IVc of the classification of BI-RADS detected by SVABB biopsy method were 5.59%,27.45%,and 58.35%,respectively;the proportions of stage IV,stage IVb,and stage IVc of the classification of BI-RADS detected by surgical biopsy method were 4.92%,21.74%,and 42.86%,respectively,there was statistically significant difference between the two methods(P<0.05).There was statistically significant difference in operation time,the amount of blood loss during operation,hospitalization time,medical fee,the size of scar,breast skin depression,transposition of nipple,and postoperative hematoma between the two methods(P<0.05).Conclusion:SVABB is an accurate,safe,and simple diagnostic method,which can be used as the first choice for diagnosis of breast calcification,so the method is worthy to be popularized and spread.