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立体定向粗针穿刺活检与金属丝定位活检诊断乳腺癌后乳房肿瘤切除术的范围

Extent of lumpectomy for breast cancer after diagnosis by stereotactic core versus wire localization biopsy.

作者信息

Al-Sobhi S S, Helvie M A, Pass H A, Chang A E

机构信息

Division of Surgical Oncology, University of Michigan Cancer Center, Ann Arbor, USA.

出版信息

Ann Surg Oncol. 1999 Jun;6(4):330-5. doi: 10.1007/s10434-999-0330-y.

Abstract

BACKGROUND

Stereotactic core biopsy of mammographically defined breast abnormalities is an alternative to wire localization biopsy. The purpose of this study was to evaluate the extent of lumpectomy in patients diagnosed by stereotactic core versus wire localization biopsy.

METHODS

A total of 67 consecutive patients diagnosed with invasive cancers or ductal carcinoma in situ (DCIS) were retrospectively reviewed. Thirty-four were diagnosed by core biopsy and the remaining 33 by wire localization biopsy.

RESULTS

Approximately 65% of patients subsequently had breast-conserving surgical therapy. Seventy-nine percent of patients undergoing wire localization biopsies had positive surgical margins. Achievement of negative surgical margins for lumpectomies performed after wire localization or stereotactic core biopsies was 100% and 89%, respectively, which was not significantly different. However, the total volume of breast tissue removed for breast conservation in patients undergoing lumpectomy after wire localization versus core biopsies was 183 cm3 and 104 cm3, respectively, which was significantly different (P = .003).

CONCLUSIONS

Diagnosis by stereotactic core biopsies resulted in less tissue removal to achieve margin-negative lumpectomies for breast conservation. Stereotactic core biopsy is the method of choice for biopsying nonpalpable, suspicious breast lesions.

摘要

背景

对于乳腺钼靶检查发现的乳腺异常进行立体定向核心针穿刺活检是钢丝定位活检的一种替代方法。本研究的目的是评估通过立体定向核心针穿刺活检与钢丝定位活检诊断的患者保乳手术切除范围。

方法

回顾性分析67例连续诊断为浸润性癌或导管原位癌(DCIS)的患者。其中34例通过核心针穿刺活检确诊,其余33例通过钢丝定位活检确诊。

结果

约65%的患者随后接受了保乳手术治疗。接受钢丝定位活检的患者中有79%手术切缘阳性。在钢丝定位活检或立体定向核心针穿刺活检后进行的保乳手术中,实现阴性手术切缘的比例分别为100%和89%,差异无统计学意义。然而,钢丝定位活检后与核心针穿刺活检后接受保乳手术的患者切除的乳腺组织总体积分别为183 cm³和104 cm³,差异有统计学意义(P = 0.003)。

结论

立体定向核心针穿刺活检诊断可减少为实现保乳手术阴性切缘而切除组织的量。立体定向核心针穿刺活检是对不可触及的可疑乳腺病变进行活检的首选方法。

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