乳腺脓肿的恶性肿瘤发生率及超声引流的依据

Rate of malignancies in breast abscesses and argument for ultrasound drainage.

作者信息

Scott Bradford G, Silberfein Eric J, Pham Huang Q, Feanny Mark A, Lassinger Brian K, Welsh Francis J, Carrick Mathew M

机构信息

Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza #404D, Houston, TX 77030, USA.

出版信息

Am J Surg. 2006 Dec;192(6):869-72. doi: 10.1016/j.amjsurg.2006.08.060.

DOI:10.1016/j.amjsurg.2006.08.060

PMID:17161110

Abstract

BACKGROUND

Biopsy of a breast abscess wall has been performed for years without evidence. Aspiration of breast abscesses has been increasing in popularity without widespread acceptance.

METHODS

A 10-year retrospective review of 206 surgical biopsies after incision and drainage of breast abscesses. A literature review of breast abscess treated with ultrasound-guided aspiration.

RESULTS

Over 10 years, 4.37% (9/206) patients were diagnosed with malignancy in the abscess cavity wall tissue. None of the 197 patients with a negative biopsy returned with breast cancer. Single, multiple, and combined aspiration success rates of 79.8% (364/458), 11.0% (50/458), and 90.9% (482/532) with surgical intervention necessary in 9.1% (50/532). Ultrasound versus hand guidance (92.5% versus 81.9 %, P < .01) improved success rate.

CONCLUSIONS

The rate of associated malignancies with breast abscess is very low and does not warrant mandatory surgical drainage. The use of ultrasound-directed aspiration of breast abscesses is effective and should be first-line therapy.

摘要

背景

多年来一直对乳腺脓肿壁进行活检，但并无相关依据。乳腺脓肿穿刺术的应用日益广泛，但尚未被广泛接受。

方法

对206例乳腺脓肿切开引流术后的手术活检进行10年回顾性分析。对超声引导下穿刺治疗乳腺脓肿的文献进行综述。

结果

10年间，脓肿腔壁组织中有4.37%（9/206）的患者被诊断为恶性肿瘤。197例活检阴性的患者均未出现乳腺癌复发。单次、多次及联合穿刺成功率分别为79.8%（364/458）、11.0%（50/458）和90.9%（482/532），9.1%（50/532）的患者需要手术干预。超声引导与手工引导相比（92.5%对81.9%，P < 0.01）成功率更高。