Dubecz S, Petri K, Szabó E, Riedl E, Péley G, Rahóty P, Bak M, Köves I
Országos Onkológiai Intézet Altalános Sebészet-Mellkassebészet, Budapest.
Magy Seb. 2001 Aug;54(4):203-7.
Between 10.01.1997 and 09.30.1999 authors performed operations on 78 patients who had nonpalpable breast tumors. If mammography was considered abnormal during breast screening program patients were recalled. Besides clinical investigation complimentary mammograms were performed. After sonogram, and if needed, aspiration biopsy cytology (ABC) if necessary core biopsy (CB) was the next investigation. 79 operations were performed on 78 patients (one was patient had synchronous breast tumor). The mean age of the patients was 56.3 years. If the radiological investigations (R4-R5) and/or the ABC (C4-C5) or CB suggested malignancy operation was performed. Mammography suggested malignancy in 60.75% of the patients, it was suggested by ABC in 30.18%, and by CB in 55.5%. The nonpalpable tumor, suspected to be malignant was marked with a wire loop and was excised under anesthesia along with the affected breast sector. The excision and tissue-border around the tumor was checked by specimen mammography performed during the narcosis. No cryohistology was performed. After the specimen mammography, the wound was closed. The final histology of the operations showed malignancy in 40.5%. In their retrospective study the authors evaluated the complete sensitivity and the positive predictive value (PPV) of the preoperative investigations regarding the final histology. They analyse the value of preoperative mammogram, the ABC and CB in malignant and in benign cases. Early diagnosis and surgical treatment is expected to improve significantly the survival of patients with breast cancer. Reduction in the number of unnecessary operations can be expected from increasing the accuracy of radiological and cytological investigations and the adequate usage of core biopsy.
1997年1月1日至1999年9月30日期间，作者对78例触诊不到乳腺肿瘤的患者进行了手术。在乳腺筛查项目中，如果乳房X光检查被认为异常，患者会被召回。除临床检查外，还进行了补充乳房X光检查。在超声检查之后，如有必要，进行细针穿刺活检细胞学检查（ABC），必要时进行粗针活检（CB）作为下一步检查。对78例患者进行了79次手术（其中1例患者有同步乳腺肿瘤）。患者的平均年龄为56.3岁。如果放射学检查（R4 - R5）和/或ABC（C4 - C5）或CB提示为恶性，则进行手术。乳房X光检查提示60.75%的患者为恶性，ABC提示30.18%，CB提示55.5%。疑似恶性的触诊不到的肿瘤用金属丝环标记，并在麻醉下连同受影响的乳腺区段一并切除。在麻醉期间通过标本乳房X光检查检查肿瘤周围的切除组织边缘。未进行冷冻组织学检查。标本乳房X光检查后，关闭伤口。手术的最终组织学检查显示40.5%为恶性。在他们的回顾性研究中，作者评估了术前检查对于最终组织学的完全敏感性和阳性预测值（PPV）。他们分析了术前乳房X光检查、ABC和CB在恶性和良性病例中的价值。早期诊断和手术治疗有望显著提高乳腺癌患者的生存率。通过提高放射学和细胞学检查的准确性以及充分使用粗针活检，可以预期减少不必要的手术数量。
