立体定位穿刺活检术对乳腺微小病变定性诊断的探讨

目的提高乳腺X线立体定位核芯针活检(SCNB)、立体定位穿刺导丝定位活检(SNLB)对乳腺微小病变的定性诊断准确性及成功率。方法回顾性分析了118例乳腺微小病变立体定位穿刺导丝定位活检及核芯针活检的病理资料,并与手术病理结果进行对照。结果SCNB 33例中31例活检成功,24例行外科手术,恶性病变8例,良性病变16例,诊断符合率为87.5%,误诊3例(12.5%),7例随访。2例出现迷走神经反应,未完成检查。拟行SNLB 85例,83例定位成功,其中80例定位满意,满意率94%,3例定位偏离,2例定位失败,恶性病变30例,良性病变53例。结论SCNB及SNLB是目前对乳腺微小病灶定性诊断的主要方法,通过合理选择应用可提高诊断准确性及成功率。

The Value of Stereotactic Localized Biopsy in Differential Diagnosis of Breast Minute Lesions

Objective To improve the accuracy and the success rate of stereotactic core needle biopsy(SCNB) or stereotacticneedle localized biopsy(SNLB) in differential diagnosis of breast minute lesions. Methods 118 patients with minute foci detected bymammography underwent SCNB or SNLB,all data were analyzed retrospectively,and the pathology results of SCNB were compared withsurgical pathologies. Results 31 Of all the 33 patients with SCNB were punctured successfully.24 cases underwent surgical excision afterSCNB,7 of these patients were followed-up by mammography,and the other 2 failed to undergo SCNB,because of vasovagal reaction.Postoperative findings showed 8 were malignant and 16 were benign.The concordance rate and the misdiagnosis rate was 87.5%,12.5% respectively.Of the 85 cases of SNLB,83 cases were successfully located,and 80(94%) cases were done satisfyingly,3 departed.Pathologic findings revealed 30 were malignant and 53 were benign.2 of 85 failed to be located. Conclusion SCNB and SNLB are major approaches to diagnose breast minute lesions,reasonable application of the two methods can increase the accuracy and the success rate.