Kirwan S E, Denton E R, Nash R M, Humphreys S, Michell M J
Breast Screening Assessment and Training Unit, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Clin Radiol. 2000 Oct;55(10):763-6. doi: 10.1053/crad.2000.0513.
The aim of this retrospective study was to measure the accuracy of stereotactic guided 14 gauge core biopsy in distinguishing between benign and malignant causes of a mammographically detected stellate breast lesion and to assess the impact of the number of core samples taken on the sensitivity for detection of malignancy.
Seventy-two patients with mammographically detected stellate lesions of the breast formed the study group. All patients in the study group underwent multiple 14 gauge core biopsies using prone stereotactic breast biopsy equipment. The diagnostic accuracy of the technique was measured by retrospectively comparing the outcome with the core biopsy results. The result of each core sample was separately recorded to allow analysis of the effect of increasing the number of samples on accuracy.
Nine of 72 (12%) did not have surgery. Forty of 72 (56%) had a benign surgical outcome and 23/72 (32%) a malignant surgical outcome [7/72 (10%) non-invasive, 16/72 (22%) invasive carcinoma]. The absolute sensitivity for multiple stereotactic guided core biopsies of stellate lesions for the detection of malignancy was 78% with a complete sensitivity of 100%. The sensitivity for the detection of invasive carcinoma was 94% (15 out of 16 patients). No statistically significant improvement in sensitivity was shown for multiple samples vs one sample, but in two patients, malignant tissue was only found in core samples 6-9, the first five cores showing atypia only.
Multiple stereotactic guided 14 gauge core biopsies accurately distinguish malignant from benign causes of stellate breast lesions. When core biopsy histology is malignant, therapeutic surgery can be planned. When the core biopsy shows typical features of a benign radial scar, diagnostic surgical excision may not be required to confirm the diagnosis.Kirwan, S. E., (2000). Clinical Radiology55, 763-766.
本回顾性研究旨在测定立体定向引导下14G粗针活检在鉴别乳腺钼靶检查发现的星芒状乳腺病变的良性和恶性病因方面的准确性，并评估所取粗针样本数量对恶性病变检测敏感性的影响。
72例乳腺钼靶检查发现有星芒状病变的患者组成研究组。研究组所有患者均使用俯卧位立体定向乳腺活检设备进行多次14G粗针活检。通过将结果与粗针活检结果进行回顾性比较来测定该技术的诊断准确性。分别记录每个粗针样本的结果，以便分析增加样本数量对准确性的影响。
72例中有9例（12%）未进行手术。72例中有40例（56%）手术结果为良性，23/72例（32%）为恶性手术结果[7/72例（10%）非浸润性，16/72例（22%）浸润性癌]。星芒状病变多次立体定向引导粗针活检检测恶性病变的绝对敏感性为78%，完全敏感性为100%。浸润性癌的检测敏感性为94%（16例患者中的15例）。多个样本与单个样本相比，敏感性无统计学上的显著提高，但有2例患者仅在第6 - 9个粗针样本中发现恶性组织，前5个样本仅显示非典型性。
多次立体定向引导下14G粗针活检能准确区分星芒状乳腺病变的恶性和良性病因。当粗针活检组织学结果为恶性时，可规划治疗性手术。当粗针活检显示为良性放射状瘢痕的典型特征时，可能无需进行诊断性手术切除来确诊。柯万，S.E.，（2000年）。《临床放射学》55卷，第763 - 766页。
