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对8号真空辅助麦默通(Mammotome®)系统用于超声引导下乳腺病变诊断性活检及选择性切除的综合评估。

A comprehensive evaluation of the 8-gauge vacuum-assisted Mammotome(R) system for ultrasound-guided diagnostic biopsy and selective excision of breast lesions.

作者信息

Povoski Stephen P, Jimenez Rafael E

机构信息

Division of Surgical Oncology, Department of Surgery, Arthur G, James Cancer Hospital and Richard J, Solove Research Institute and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, 43210, USA.

出版信息

World J Surg Oncol. 2007 Jul 30;5:83. doi: 10.1186/1477-7819-5-83.

Abstract

BACKGROUND

Minimally invasive breast biopsy technology is now considered a standard of care for the diagnostic evaluation of suspicious breast lesions. The aim of the current study was to present a comprehensive evaluation of the 8-gauge vacuum-assisted Mammotome(R) system for ultrasound-guided diagnostic biopsy and selective excision of breast lesions.

METHODS

A retrospective analysis was conducted of a series of 304 consecutive 8-gauge Mammotome(R) procedures that were performed under ultrasound guidance by a single surgeon from March 2004 to December 2006. Multiple variables, including patient demographics, characteristics of the breast lesion (based on ultrasound and mammography), procedural and histopathology variables, and interval follow-up variables (based on ultrasound and mammography), were evaluated.

RESULTS

Among 304 procedures, 235 (77%) were performed with the presumption of complete excision of the ultrasound lesion during Mammotome(R) core acquisition, while 69 (23%) were performed with only partial excision of the ultrasound lesion during Mammotome(R) core acquisition (diagnostic tissue sampling only). 100% of all ultrasound lesions were accurately diagnosed, demonstrating no apparent false-negative results among the 256 patients that were compliant with follow-up at a median interval follow-up duration of 11 months (range 1 to 37). Likewise, 89% of all appropriately selected ultrasound lesions were completely excised, as demonstrated on interval follow-up ultrasound at a median time of 6 months (range, 3 to 16). There were no independent predictors of successful complete excision of any given appropriately selected ultrasound lesion by the ultrasound-guided 8-gauge Mammotome(R) biopsy technique.

CONCLUSION

The 8-gauge vacuum-assisted Mammotome(R) system is highly accurate for ultrasound-guided diagnostic biopsy of suspicious breast lesions and is highly successful for complete excision of appropriately selected presumed benign breast lesions. This particular technology should be routinely offered to all appropriately selected patients that are evaluated by physicians involved in breast-specific health care.

摘要

背景

微创乳腺活检技术目前被视为对可疑乳腺病变进行诊断评估的护理标准。本研究的目的是对8号真空辅助麦默通(Mammotome)系统用于超声引导下乳腺病变的诊断性活检和选择性切除进行全面评估。

方法

对2004年3月至2006年12月期间由一名外科医生在超声引导下连续进行的304例8号麦默通手术进行回顾性分析。评估了多个变量,包括患者人口统计学特征、乳腺病变特征(基于超声和乳腺X线摄影)、手术和组织病理学变量以及随访间隔变量(基于超声和乳腺X线摄影)。

结果

在304例手术中,235例(77%)在麦默通取芯过程中假定完全切除超声病变,而69例(23%)在麦默通取芯过程中仅部分切除超声病变(仅用于诊断性组织取样)。所有超声病变的诊断准确率为100%,在256例中位随访间隔为11个月(范围1至37个月)且接受随访的患者中未显示明显假阴性结果。同样,在中位时间为6个月(范围3至16个月)的随访超声检查中,89%的所有适当选择的超声病变被完全切除。超声引导下8号麦默通活检技术对任何给定的适当选择的超声病变成功完全切除没有独立预测因素。

结论

8号真空辅助麦默通系统在超声引导下对可疑乳腺病变进行诊断性活检具有高度准确性,对适当选择的假定为良性的乳腺病变进行完全切除也非常成功。这种特定技术应常规提供给所有由参与乳腺专科医疗保健的医生评估的适当选择的患者。

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