Cosmacini P, Veronesi P, Zurrida S, Sacchini V, Ferranti C, Galimberti V, Luini A, Viganotti G, Coopmans De Yoldi G
Divisione di Radiologia B, IRCCS Ospedale San Raffaele, Milano.
Radiol Med. 1992 Apr;83(4):383-9.
The widespread use of mammography in breast cancer screening has increased the number of non-palpable breast lesions being detected in which the differential diagnosis between benign and malignant cases requires surgical biopsy. In order to remove these mammographically identified lesions the surgeon must be guided, which is why the techniques guiding the surgeon during lesions ablation have become most important. Accurate preoperative lesion localization must be done so that the excision can be complete and with the best cosmetic result. In this report we discuss localization methods, from the simplest to the most complicated ones. The commonest method has the advantage of employing no special instruments, and it is very simple, safe and fast. It requires a skilled hand and a little training. Instrumental methods are then discussed, from the simple dedicated compressor to the stereotactic techniques and, finally, the role of ultrasonography both in preoperative localization and in cytologic biopsy. The importance of mammographic examination of the surgical specimen is also stressed.
乳腺钼靶摄影在乳腺癌筛查中的广泛应用增加了不可触及乳腺病变的检出数量,对于这些病变,良性与恶性病例的鉴别诊断需要进行手术活检。为了切除这些经乳腺钼靶检查发现的病变,外科医生必须得到引导,这就是为什么在病变切除过程中引导外科医生的技术变得至关重要。必须进行准确的术前病变定位,以便能够完整切除病变并获得最佳的美容效果。在本报告中,我们将讨论从最简单到最复杂的定位方法。最常见的方法具有无需特殊器械的优点,而且非常简单、安全且快速。它需要熟练的操作手法和一点培训。接着讨论器械方法,从简单的专用压迫器到立体定向技术,最后讨论超声检查在术前定位和细胞学活检中的作用。还强调了对手术标本进行乳腺钼靶检查的重要性。