经针芯活检诊断的乳腺放射状瘢痕病变：隐匿性恶性肿瘤病例分析
Radial scar lesions of the breast diagnosed by needle core biopsy: analysis of cases containing occult malignancy.
作者信息
Douglas-Jones Anthony G, Denson Jemimah L, Cox Adam C, Harries Iwan B, Stevens Guy
机构信息
Department of Pathology, School of Medicine, Cardiff University, Cardiff, UK.
出版信息
J Clin Pathol. 2007 Mar;60(3):295-8. doi: 10.1136/jcp.2006.037069. Epub 2006 May 26.
Abstract
AIM
To identify and review cases of false negative needle core biopsy (NCB) in the preoperative investigation of radial scar/complex sclerosing lesion (RS/CSL) lesions - that is, benign NCB from RS/CSL which contained malignancy on excision.
METHODS AND RESULTS
A total of 11 false negative NCB in RS/CSL lesions from 281 (3.9%) were identified (6 cases: B1, 2 cases: B2 and 3 cases: B3). In 6 of 11 cases a radial scar or stromal sclerosis was seen in NCB. Localisation biopsy showed duct carcinoma in situ in six cases, duct carcinoma in situ with invasive carcinoma in three and invasive carcinoma in two. In all 11 cases, needle tracks were identified as missing the malignant epithelium by a mean of 5 mm (median:4 mm; range:1-20 mm). In 9 of 11 cases, the malignancy was missed by <6 mm.
CONCLUSIONS
Despite evidence of accurate targeting of lesions, the use of NCB instead of fine needle aspiration cytology has not eliminated the problem of false negative biopsy in RS/CSL, and excision is recommended.
摘要
目的
识别并回顾在术前检查中经皮穿刺活检针（NCB）对放射状瘢痕/复杂性硬化性病变（RS/CSL）出现假阴性的病例，即对RS/CSL进行的NCB检查结果为良性，但切除后发现存在恶性肿瘤。
方法与结果
在281例RS/CSL病变中，共识别出11例假阴性NCB病例（占3.9%）（B1期6例、B2期2例、B3期3例）。11例中有6例在NCB中可见放射状瘢痕或间质硬化。局部活检显示，6例为导管原位癌，3例为导管原位癌伴浸润性癌，2例为浸润性癌。在所有11例病例中，经确认穿刺针道平均偏离恶性上皮5毫米（中位数：4毫米；范围：1 - 20毫米）。11例中有9例，恶性肿瘤的漏检距离小于6毫米。
结论
尽管有证据表明对病变的靶向定位准确，但使用NCB而非细针穿刺抽吸细胞学检查并未消除RS/CSL活检假阴性的问题，因此建议进行切除。
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