Lifrange E, Dondelinger R F, Foidart J M, Bradfer J, Quatresooz P, Colin C
Breast Department, University Hospital Sart Tilman, Liège, Belgium.
Breast. 2002 Dec;11(6):501-8. doi: 10.1054/brst.2002.0464.
Recently, the advanced breast biopsy instrumentation (ABBI) system has been introduced as an alternative to conventional breast biopsy techniques. This study was prospectively conducted to evaluate the potential of the ABBI method in locoregional management of a consecutive series of patients with nonpalpable mammographically detected breast carcinomas. Sixty-one consecutive patients underwent an ABBI procedure as a first step before possible surgery for nonpalpable breast lesions that would in any case require complete excision. For the 27 patients in whom the ABBI biopsy revealed malignancy further surgery was recommended, including re-excision of the biopsy site and axillary dissection in cases of infiltrating carcinoma. We calculated the probabilities that the ABBI specimen would have tumor-free margins and that a definitely complete excision had been achieved as a function of the mammographic or pathological diameter of the cancer. For cancer with a pathological diameter less than 10 mm measured on the ABBI specimen, the probability (92%) of obtaining complete resection was significantly better than for larger lesions (P=0.01, Fisher's exact test). Although the therapeutic perspectives for the ABBI method are limited at present, we suggest that this approach is a first step in the direction of a surgical strategy that is better adapted to the pathological characteristics peculiar to these small tumors, whose incidence is increasing.
最近，先进乳腺活检器械（ABBI）系统作为传统乳腺活检技术的替代方法被引入。本研究前瞻性地评估了ABBI方法在一系列连续的乳腺钼靶检查发现的不可触及乳腺癌患者局部区域管理中的潜力。61例连续患者接受了ABBI手术，作为对任何情况下都需要完整切除的不可触及乳腺病变进行可能手术前的第一步。对于27例ABBI活检显示为恶性肿瘤的患者，建议进一步手术，包括对活检部位进行再次切除，对于浸润性癌患者进行腋窝清扫。我们计算了ABBI标本切缘无肿瘤以及实现明确完整切除的概率，这是癌症钼靶或病理直径的函数。对于ABBI标本上病理直径小于10mm的癌症，获得完整切除的概率（92%）明显优于较大病变（P = 0.01，Fisher精确检验）。尽管目前ABBI方法的治疗前景有限，但我们认为这种方法是朝着更适合这些小肿瘤病理特征的手术策略迈出的第一步，而这些小肿瘤的发病率正在上升。
