Ghosh Karthik, Melton L Joseph, Suman Vera J, Grant Clive S, Sterioff Sylvester, Brandt Kathy R, Branch Charles, Sellers Thomas A, Hartmann Lynn C
Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Arch Intern Med. 2005 Jul 25;165(14):1593-8. doi: 10.1001/archinte.165.14.1593.
Breast biopsy, to determine the nature of a clinical or radiographic breast abnormality, was presumed to have increased in frequency with the widespread use of screening mammography. However, scant data exist regarding the utilization of breast biopsies in the community population.
Through the resources of the Rochester Epidemiology Project, the medical records of women 18 years and older who had a breast biopsy from January 1, 1988, through December 31, 1999, were reviewed for the type of biopsy, presentation at biopsy, and tissue pathological findings. The overall and age-specific utilization rates of breast biopsies were assessed, as were changes in the breast biopsy technique after the introduction of image-guided core-needle biopsy in 1992.
The overall annual utilization rate of breast biopsies was 62.6 per 10 000 women per year and remained stable throughout the study. Excisional breast biopsies showed a decreasing trend and core-needle biopsies increased during the study duration. The age-adjusted incidence of benign results of breast biopsies for the study duration was 38.9 per 10 000 women. The benign-malignant ratio remained constant despite changes in the biopsy procedure.
This population-based study provides much-needed data regarding the frequency of breast biopsies and benign results of breast biopsies in a community population. The utilization rate of breast biopsies remained fairly constant throughout the study period despite the introduction of the image-guided, core-needle biopsy procedure in 1992. A multidisciplinary breast practice, along with established guidelines for breast biopsy, can ensure appropriate use of new technology and thereby improve patient care.
乳腺活检用于确定临床或影像学检查发现的乳腺异常的性质，据推测，随着乳腺钼靶筛查的广泛应用，其使用频率有所增加。然而，关于社区人群乳腺活检利用情况的数据却很少。
通过罗切斯特流行病学项目的资源，对1988年1月1日至1999年12月31日期间接受乳腺活检的18岁及以上女性的病历进行回顾，以了解活检类型、活检时的表现及组织病理学结果。评估了乳腺活检的总体及年龄特异性利用率，以及1992年引入影像引导下粗针活检后乳腺活检技术的变化。
乳腺活检的总体年利用率为每10000名女性每年62.6例，在整个研究期间保持稳定。在研究期间，乳腺切除活检呈下降趋势，而粗针活检则有所增加。研究期间乳腺活检良性结果的年龄调整发病率为每10000名女性38.9例。尽管活检程序有所变化，但良性与恶性比例保持不变。
这项基于人群的研究提供了社区人群中乳腺活检频率及乳腺活检良性结果急需的数据。尽管1992年引入了影像引导下粗针活检程序，但在整个研究期间，乳腺活检的利用率保持相当稳定。多学科乳腺诊疗，以及既定的乳腺活检指南，可确保新技术的合理使用，从而改善患者护理。
