Fehr M K, Hornung R, Von Orelli S, Haller U
Klinik für Gynäkologie, Departement Frauenheilkunde, Universitätsspital Zürich, Schweiz, Switzerland.
Gynakol Geburtshilfliche Rundsch. 2002;42(4):201-11. doi: 10.1159/000065161.
An optimal technique for the evaluation of nonpalpable, suspicious mammographic lesions should have a low technical failure rate, no false-negative results and should remove the lesion completely. Since most of these lesions are benign, the procedure should be carried out in an outpatient setting without general anesthesia. Cancer is missed in 2.6% of cases with excisional biopsy following needle localization. Furthermore, 50-83% of these patients undergo a second surgical intervention for definitive surgical treatment. In contrast, the rate of missed cancers is less than 0.7% following stereotaxic core or large-core biopsies. However, using these techniques, discordant results and histologic high-risk lesions need to be recognized and reexcized. The cost-effectiveness of stereotaxic vacuum-assisted core biopsy has been demonstrated. Stereotaxic breast biopsy techniques such as vacuum-assisted core biopsy and large-core biopsy for suspicious mammographic lesions have low false-negative rates and result in few histologic underestimations.
评估乳腺钼靶检查中不可触及的可疑病变的最佳技术应具备较低的技术失败率、无假阴性结果，并且应能完全切除病变。由于这些病变大多为良性，该操作应在门诊进行，无需全身麻醉。针定位后切除活检的病例中，有2.6%的癌症被漏诊。此外，这些患者中有50 - 83%需要进行二次手术干预以进行确定性手术治疗。相比之下，立体定向空心针或粗针活检后癌症漏诊率低于0.7%。然而，使用这些技术时，需要识别并再次切除不一致的结果和组织学高危病变。立体定向真空辅助空心针活检的成本效益已得到证实。用于乳腺钼靶可疑病变的立体定向乳腺活检技术，如真空辅助空心针活检和粗针活检，假阴性率低，组织学低估情况少。
