乳腺X线立体定位空芯针活检的临床应用

目的评价乳腺X线立体定位空芯针活检在乳腺疾病诊治中的价值.方法采用计算机辅助乳腺X线立体定位系统、弹射式自动活检枪和14-gauge的空芯针.结果对影像学诊断发现异常的71个病灶进行X线立体定位空芯针活检.对照手术或1年以上(13～45个月)的随访结果,该组的诊断特异性和敏感性分别为100％和92％.有73％的良性病灶经空芯针活检明确诊断后免除了手术活检.结论 X线立体定位空心针活检是用于乳腺X线发现的临床摸不到肿块的病灶的一种安全有效的微创活检方法,并使大量良性病变免除手术活检并节省了医疗开支.

Clinical practice of stereotactic core needle biopsy for breast lesion

Objective The breast screening for women older than 40 with mammography could increase the detection rate of early breast cancer, thus decrease the mortality of this disease. With the widely spread of this screen technique, more and more mammographically detected breast lesions are required for biopsy. The purpose of this study is to examine whether and how stereotactic core needle biopsy (SCNB) could play a significant role in diagnosis and management for such kind of lesions. Methods A computer assisted stereotactic mammograph was used as a guidance for those non palpable lesions. Core needle biopsy was performed by a spring loaded automatic biopsy gun with a 14 gauge needle.Results SCNB were carried out for 71 mammographicly detected breast lesions from 70 women. The percentages of non palpable lesions and micro calcifications were 90% and 85%, respectively. The results of SCNB are: 21 malignancies (8 invasive ductal carcinomas, 13 ductal carcinomata in situ (DCIS), 3 atypical duct hyperplacia (ADH)s, 46 benign lesions and 1 non diagnosed lesion which was due to insufficient sample collection. The specificity and sensitivity of SCNB according to the results from surgical biopsy or 18 month median follow up time (6 33 months) were 100% and 92%. Seventy three of the benign lesions spared the surgical processes and just followed up by mammography. Conclusion SCNB is a safe and effective micro invasive procedure for lesions detected by mammography. It could save the surgical biopsy for most of the benign lesions and thus decrease the cost of diagnostic process.