Fortunato L, Penteriani R, Farina M, Vitelli C E, Piro F R
Department of Surgery, S. Giovanni Addolorata Hospital, Via Amba Aradam 4, 00184 Rome, Italy.
Eur J Surg Oncol. 2008 Dec;34(12):1289-92. doi: 10.1016/j.ejso.2007.11.011. Epub 2008 Jan 14.
Non-palpable breast tumors represent an increasing management problem in modern Breast Units. Therefore, a simple and accurate procedure to localize these lesions is needed. To date, the most commonly used technique is wire localization, but there are some disadvantages.
We conducted a prospective study on patients with malignant or benign non-palpable breast tumors who were surgically treated and underwent intraoperative ultrasound (IOUS) from May 2006 to June 2007. Margins of excision were inked and specifically assessed by the pathologist, and were considered positive if <or=1 mm.
There were 77 patients (60 malignant and 17 benign lesions), with a median age of 54 years (36-87), and a median diameter of 9mm (4-17). All lesions were correctly identified and localized by IOUS, and free margins of excision were obtained in 75/77 cases (97%). Only two patients required a re-excision, one for multifocal disease and one for margins of excision of 1mm. In the remaining cases, the median distance from the tumor to the closest margins of excision, with exclusion of the posterior (fascial) and anterior (skin) margins, was 1.3cm (0.3-3.2).
IOUS is a simple and accurate procedure that can be used to identify most non-palpable breast tumors, and has many advantages over the more commonly used wire-localization technique.
在现代乳腺科，不可触及的乳腺肿瘤的处理成为一个日益棘手的问题。因此，需要一种简单且准确的方法来定位这些病变。迄今为止，最常用的技术是金属丝定位，但存在一些缺点。
我们对2006年5月至2007年6月期间接受手术治疗并术中接受超声检查（IOUS）的恶性或良性不可触及乳腺肿瘤患者进行了一项前瞻性研究。切除边缘用墨水标记，由病理学家进行专门评估，如果≤1毫米则认为切除边缘阳性。
共有77例患者（60例恶性病变和17例良性病变），中位年龄54岁（36 - 87岁），中位直径9毫米（4 - 17毫米）。所有病变均通过IOUS正确识别和定位，77例中有75例（97%）获得了切缘阴性。仅2例患者需要再次切除，1例因多灶性疾病，1例因切除边缘为1毫米。在其余病例中，排除后（筋膜）和前（皮肤）边缘后，肿瘤到最近切除边缘的中位距离为1.3厘米（0.3 - 3.2厘米）。
IOUS是一种简单且准确的方法，可用于识别大多数不可触及的乳腺肿瘤，与更常用的金属丝定位技术相比具有许多优势。
