Mathew J, Crawford D J, Lwin M, Barwick C, Gash A
Department of Surgery, Ysbyty Gwynedd, Bangor, UK.
Ann R Coll Surg Engl. 2007 Jul;89(5):494-6. doi: 10.1308/003588407X187621.
Ultrasound-guided, vacuum-assisted biopsy has a definitive role in the diagnosis of breast lesions. Its role in the treatment of benign breast lesions like fibroadenomas has not been established.
This is a retrospective review of patients undergoing ultrasound-guided, vacuum-assisted biopsy for clinically benign breast lesions. The procedures were performed in all cases by two consultant radiologists with special interest in breast radiology between February 2002 and January 2004. Patients were followed up in the clinic 6 weeks after the procedure.
Seventy-six patients had ultrasound-guided, vacuum-assisted excision of clinically benign breast lesions during this 2-year period. Mean age of the patients was 31 years. Altogether, 86 procedures were performed. Six patients with larger lesions (> 2 cm) had two procedures on separate sitting and 4 patients had separate lesions excised on a later date. Fifty-six patients were identified to have fibroadenomas and had complete excisions as evidenced on scan. Three out of nine patients identified with equivocal disease on fine needle aspiration cytology (FNAC) were found to have cancer following ultrasound-guided, vacuum-assisted excision. One patient who was diagnosed with cancer on FNAC, proved to be fibroadenoma on final histopathology. Four patients developed haematomas following ultrasound-guided, vacuum-assisted excision and all were managed conservatively.
Our study shows that ultrasound-guided, vacuum-assisted excision can play an efficient role in the diagnosis of benign breast lesions and is a safe and successful alternative in treatment of fibroadenomas.
超声引导下真空辅助活检在乳腺病变诊断中具有明确作用。其在治疗如纤维腺瘤等良性乳腺病变中的作用尚未确立。
这是一项对接受超声引导下真空辅助活检的临床诊断为良性乳腺病变患者的回顾性研究。所有操作均由两位对乳腺放射学有专门兴趣的放射科顾问医生在2002年2月至2004年1月期间进行。术后6周在门诊对患者进行随访。
在这两年期间,76例患者接受了超声引导下真空辅助切除临床诊断为良性的乳腺病变。患者平均年龄为31岁。总共进行了86次操作。6例病变较大(>2 cm)的患者分两次进行操作,4例患者在之后的日期切除了不同的病变。56例患者经扫描证实为纤维腺瘤并完整切除。在细针穿刺细胞学检查(FNAC)中诊断为可疑病变的9例患者中,有三例在超声引导下真空辅助切除后被发现患有癌症。1例在FNAC中被诊断为癌症的患者,最终组织病理学检查证实为纤维腺瘤。4例患者在超声引导下真空辅助切除后出现血肿,均采取保守治疗。
我们的研究表明,超声引导下真空辅助切除在良性乳腺病变诊断中可发挥有效作用,并且是治疗纤维腺瘤的一种安全且成功的替代方法。