Morrow M, Venta L, Stinson T, Bennett C
Lynn Sage Breast Center and the Department of Surgery, Northwestern University, Chicago, Illinois, USA.
Ann Surg. 2001 Apr;233(4):537-41. doi: 10.1097/00000658-200104000-00009.
To determine whether stereotactic core biopsy (SCNB) is the diagnostic method of choice for all mammographic abnormalities requiring tissue sampling.
Stereotactic core needle biopsy decreases the cost of diagnosis, but its impact on the number of surgical procedures needed to complete local therapy has not been studied in a large, unselected patient population.
A total of 1,852 mammographic abnormalities in 1,550 consecutive patients were prospectively categorized for level of cancer risk and underwent SCNB or diagnostic needle localization and surgical excision. Diagnosis, type of cancer surgery, and number of surgical procedures to complete local therapy were obtained from surgical and pathology databases.
The malignancy rate was 24%. Surgical biopsy patients were older, more likely to have cancer, and more likely to be treated with breast-conserving therapy than those in the SCNB group. For all types of lesions, regardless of degree of suspicion, patients diagnosed by SCNB were almost three times more likely to have one surgical procedure. However, for patients treated with lumpectomy alone, the number of surgical procedures and the rate of negative margins did not differ between groups.
Stereotactic core needle biopsy is the diagnostic procedure of choice for most mammographic abnormalities. However, for patients undergoing lumpectomy without axillary surgery, it is an extra invasive procedure that does not facilitate obtaining negative margins.
确定立体定向核心活检（SCNB）是否为所有需要组织采样的乳腺钼靶异常的首选诊断方法。
立体定向核心针活检降低了诊断成本，但尚未在大量未经选择的患者群体中研究其对完成局部治疗所需手术数量的影响。
对1550例连续患者中的1852处乳腺钼靶异常进行前瞻性癌症风险分级，并接受SCNB或诊断性针定位及手术切除。从手术和病理数据库中获取诊断、癌症手术类型以及完成局部治疗的手术数量。
恶性率为24%。与SCNB组相比，手术活检患者年龄更大，患癌可能性更高，且更有可能接受保乳治疗。对于所有类型的病变，无论可疑程度如何，经SCNB诊断的患者进行一次手术的可能性几乎是其他患者的三倍。然而，对于仅接受乳房肿块切除术的患者，两组之间的手术数量和切缘阴性率并无差异。
立体定向核心针活检是大多数乳腺钼靶异常的首选诊断方法。然而，对于未进行腋窝手术的乳房肿块切除术患者，它是一种额外的侵入性操作，不利于获得阴性切缘。
