Kim Min Jung, Kim Eun-Kyung, Kwak Jin Young, Son Eun Ju, Park Byeong-Woo, Kim Seung-Il, Oh Ki Keun
Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seodaemun-ku Shinchon-dong 134, Seoul, 120-752, South Korea.
Eur Radiol. 2008 Sep;18(9):1774-83. doi: 10.1007/s00330-008-0960-7. Epub 2008 Apr 30.
This study was conducted to assess the accuracy of US-guided directional vacuum-assisted removal (US-DVAR) in evaluating nonmalignant papillary breast lesions. This retrospective study was approved by the institutional review board at our institution; patient consent was not required. We reviewed the clinical and pathology findings from a total of 39 papillary lesions diagnosed at vacuum-assisted removal in 37 patients (age range, 26-60 years; mean age, 44.5 years). Over the follow-up period, we evaluated whether any histologic upgrade occurred and whether or not residual lesions were detected on follow-up imaging. US-DVAR of 39 lesions yielded tissue that was classified as benign in 35 and atypical in 4. Of the 35 lesions that were diagnosed as histologically benign at US-DVAR, 2 were surgically excised. Both of them yielded benign results. Of the 33 benign lesions that were not surgically excised, 28 (85%) were not seen at radiographic follow-up. Of the four lesions diagnosed as atypical at US-DVAR that were surgically excised, all the four were benign. None proved to be malignant. The upgrade rate was 0.0% (95% confidence interval, 0-9%). Among our patients, diagnosis by US-DVAR of benign papillary lesions proved to be accurate, and benign papillary lesions at US-DVAR did not need to be surgically excised for accurate diagnosis.
本研究旨在评估超声引导下定向真空辅助切除（US-DVAR）在评估非恶性乳腺乳头状病变中的准确性。本回顾性研究经我院机构审查委员会批准；无需患者同意。我们回顾了37例患者（年龄范围26 - 60岁，平均年龄44.5岁）经真空辅助切除诊断的39个乳头状病变的临床和病理结果。在随访期间，我们评估是否发生任何组织学升级以及随访影像检查中是否检测到残留病变。39个病变的US-DVAR所获取的组织中，35个被分类为良性，4个为非典型性。在US-DVAR时被诊断为组织学良性的35个病变中，2个接受了手术切除。两者均为良性结果。在未接受手术切除的33个良性病变中，28个（85%）在影像学随访中未被发现。在US-DVAR时被诊断为非典型性且接受手术切除的4个病变中，全部4个均为良性。无一个被证明为恶性。升级率为0.0%（95%置信区间，0 - 9%）。在我们的患者中，US-DVAR对良性乳头状病变的诊断被证明是准确的，并且US-DVAR诊断为良性的乳头状病变无需手术切除即可获得准确诊断。
