Makoske T, Preletz R, Riley L, Fogarty K, Swank M, Cochrane P, Blisard D
Department of Surgery, St. Luke's Hospital and Health Network, Bethlehem, Pennsylvania, 18015, USA.
Am Surg. 2000 Dec;66(12):1104-8; discussion 1108-9.
Stereotactic core needle biopsies (SCNBs) are accurate and relatively convenient for the patient; however, the long-term follow-up of benign results has not been reported. All patients between 1993 and 1998 undergoing SCNB at a community-based hospital were entered into a registry. Follow-up was obtained by a retrospective analysis of the charts. Biopsies were performed on 865 lesions. One hundred thirty-one (15%) were malignant, 42 (5%) were suspicious for malignancy, 687 (79%) were benign, and five (1%) were lobular carcinoma in situ. Of the 42 patients with suspicious findings 38 underwent biopsy. Ten were malignant and 28 benign. Of the 687 patients with benign pathology, 377 had follow-up available with a mean length of 1.7 years. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SCNB for benign lesions in our study are all 100 per cent. Eight lesions were worrisome and await final analysis. Of 687 patients with benign lesions 310 were lost to follow-up. This study suggests that patients with a benign diagnosis should be returned to routine mammography. These data also extend the reported follow-up to 1.7 years and establish an acceptable level of accuracy for SCNB. The lost patients remind us that follow-up is essential despite a benign diagnosis.
立体定向粗针活检（SCNB）对患者而言准确且相对便捷；然而，关于良性结果的长期随访情况尚未见报道。1993年至1998年间在一家社区医院接受SCNB的所有患者均被纳入登记系统。通过对病历的回顾性分析进行随访。共对865个病灶进行了活检。其中131个（15%）为恶性，42个（5%）疑为恶性，687个（79%）为良性，5个（1%）为小叶原位癌。在42例疑有异常发现的患者中，38例接受了活检。其中10例为恶性，28例为良性。在687例病理结果为良性的患者中，377例有随访资料，平均随访时长为1.7年。在我们的研究中，SCNB对良性病灶的敏感性、特异性、阳性预测值、阴性预测值及准确性均为100%。有8个病灶情况令人担忧，有待最终分析。在687例良性病灶患者中，310例失访。本研究表明，诊断为良性的患者应恢复常规乳腺钼靶检查。这些数据还将已报道的随访时间延长至1.7年，并确立了SCNB可接受的准确性水平。失访患者提醒我们，尽管诊断为良性，但随访至关重要。
