Weikel W, Hofmann M, Steiner E, Bohrer M, Layer G
Universitäts-Frauenklinik Mainz.
Zentralbl Gynakol. 2004 Apr;126(2):87-92. doi: 10.1055/s-2004-818774.
Screening mammography (as planned in Germany) will lead to an increasing number of breast biopsies. The purpose of this study was to determine the promise of directional large core biopsy as a patient-protecting therapeutic method.
166 vacuum assisted, X-ray-guided biopsy procedures were analysed.
Histopathologic examination resulted in 75.8 % benign lesions. Atypical proliferation and noninvasive neoplasia was found in 18.6 %, invasive carcinoma in 5.4 % of the biopsies. Complications were few. Neither skin- or chestwall injuries, nor pain or intraoperative bleeding caused an abortion. Postoperative we found four cases of bleeding, further on in 28.3 % a superficial, in 3 % a larger and deep hematoma, but in total without any operative revision. No infection was diagnosed. In the average 17.2 (8-31) specimens were removed. After excision of 18 probes the definitive histopathologic diagnosis was clear in all cases, also, the microcalcifications were found. The underestimation rate amounted to 3 of 35 cases.
This clinical study proves stereotactic vacuum-assisted biopsy as a relieable method for analysing indeterminate mammographically detected breast lesions, which shows lower rates of complications than conventional surgical procedures.
乳腺筛查钼靶检查(如德国所计划的那样)将导致乳腺活检数量增加。本研究的目的是确定定向大芯针活检作为一种保护患者的治疗方法的前景。
分析了166例真空辅助、X线引导下的活检操作。
组织病理学检查显示75.8%为良性病变。18.6%的活检发现非典型增生和非浸润性肿瘤,5.4%为浸润性癌。并发症很少。皮肤或胸壁损伤、疼痛或术中出血均未导致手术中止。术后发现4例出血,此外,28.3%出现浅表血肿,3%出现较大的深部血肿,但总体上无需任何手术修正。未诊断出感染。平均取出17.2(8 - 31)个标本。在切除18个探头后,所有病例的最终组织病理学诊断均明确,同时也发现了微钙化。低估率为35例中的3例。
这项临床研究证明立体定向真空辅助活检是分析钼靶检查发现的不确定乳腺病变的可靠方法,其并发症发生率低于传统手术。