Agarwal T, Patel B, Rajan P, Cunningham D A, Darzi A, Hadjiminas D J
Breast Care Unit and Academic Surgical Unit, St. Mary's Hospital, London, UK.
Eur J Cancer. 2003 Jan;39(1):52-6. doi: 10.1016/s0959-8049(02)00459-8.
The aim of this study was to assess the efficacy of free-hand percutaneous core biopsy (FHCB) and to determine the role of fine needle aspiration cytology (FNAC) as diagnostic tools for palpable radiologically-suspicious breast lumps. This retrospective study was based on reviewing the clinical records of all patients diagnosed as having breast cancer between January 1999 and December 2000 and patients who had benign lesions, but suspicious breast imaging at triple assessment. Absolute sensitivity of FHCB for diagnosing cancer in palpable lesions was 98.7% compared with 51.3% for FNAC. The difference in the sensitivity of FHCB and FNAC was statistically significant (P<0.005, Wilcoxon matched pair test). Since 94.8% of radiologically-suspicious lumps were shown to be cancers, we advocate FHCB for all patients presenting with radiologically suspicious palpable lumps to our breast clinic. We also conclude that the sensitivity of FHCB for the diagnosis of malignancy in palpable radiologically-suspicious breast lesions is so high that image-guidance is unnecessary.
本研究旨在评估徒手经皮芯针活检（FHCB）的疗效，并确定细针穿刺抽吸细胞学检查（FNAC）作为可触及的放射学可疑乳腺肿块诊断工具的作用。这项回顾性研究基于对1999年1月至2000年12月期间所有被诊断患有乳腺癌的患者以及患有良性病变但在三联评估中乳腺影像可疑的患者的临床记录进行回顾。FHCB对可触及病变中癌症诊断的绝对敏感性为98.7%，而FNAC为51.3%。FHCB和FNAC敏感性的差异具有统计学意义（P<0.005，Wilcoxon配对检验）。由于94.8%的放射学可疑肿块被证实为癌症，我们提倡对所有前来我们乳腺诊所就诊、有放射学可疑可触及肿块的患者进行FHCB。我们还得出结论，FHCB对可触及的放射学可疑乳腺病变中恶性肿瘤诊断的敏感性非常高，以至于无需影像引导。
