立体定位真空辅助乳腺活检诊断的非典型导管增生的发生率及升级率：9号与11号针的比较

Frequency and upgrade rates of atypical ductal hyperplasia diagnosed at stereotactic vacuum-assisted breast biopsy: 9-versus 11-gauge.

作者信息

Eby Peter R, Ochsner Jennifer E, DeMartini Wendy B, Allison Kimberly H, Peacock Sue, Lehman Constance D

机构信息

Department of Radiology, University of Washington Medical Center, Seattle, WA, USA.

出版信息

AJR Am J Roentgenol. 2009 Jan;192(1):229-34. doi: 10.2214/AJR.08.1342.

DOI:10.2214/AJR.08.1342

PMID:19098204

Abstract

OBJECTIVE

Our goals were to determine the frequency and upgrade rate for atypical ductal hyperplasia (ADH) diagnosed with stereotactic 9-gauge vacuum-assisted breast biopsy and to compare the frequencies and upgrade rates of ADH between 9- and 11-gauge vacuum-assisted breast biopsy.

MATERIALS AND METHODS

We retrospectively reviewed the pathology results of 991 consecutive 9- or 11-gauge stereotactic vacuum-assisted breast biopsy procedures from February 2001 through June 2006 and identified lesions diagnosed as ADH. The final diagnosis after surgical excision was determined from medical records. The frequencies and upgrade rates to carcinoma were calculated for all ADH lesions and compared between 9- and 11-gauge procedures. The number of core samples was recorded and compared.

RESULTS

One hundred forty-one of 991 (14.2%) lesions yielded a diagnosis of ADH at 9- or 11-gauge stereotactic vacuum-assisted breast biopsy. Upgrade to ductal carcinoma in situ or invasive carcinoma occurred in 26 of 123 (21.1%) patients. The frequency of ADH was 83 of 600 (13.8%) lesions for 9-gauge and 58 of 391 (14.8%) lesions for 11-gauge vacuum-assisted breast biopsy. The 9-gauge upgrade rate was 16 of 74 (21.6%) lesions compared with 10 of 49 (20.4%) lesions for 11-gauge vacuum-assisted breast biopsy. There was no significant difference between the number of core samples obtained with each device (p=0.40). Neither the frequency of ADH (p=0.66) nor the upgrade rates (p=0.87) were significantly different between 9- and 11-gauge vacuum-assisted breast biopsy.

CONCLUSION

Compared with an 11-gauge vacuum-assisted breast biopsy device, the use of a larger 9-gauge vacuum-assisted breast biopsy needle does not decrease the upgrade rate of ADH. Our frequency of ADH at vacuum-assisted breast biopsy is higher than any previously reported and may reflect regional differences in the incidence of breast cancer or practice patterns of the pathologist.

摘要

目的

我们的目标是确定经立体定位9号真空辅助乳腺活检诊断出的非典型导管增生（ADH）的发生率及升级率，并比较9号和11号真空辅助乳腺活检中ADH的发生率及升级率。

材料与方法

我们回顾性分析了2001年2月至2006年6月期间连续进行的991例9号或11号立体定位真空辅助乳腺活检手术的病理结果，确定诊断为ADH的病变。通过病历确定手术切除后的最终诊断。计算所有ADH病变的发生率及癌升级率，并在9号和11号手术之间进行比较。记录并比较芯针活检样本数量。

结果

991例病变中有141例（14.2%）在9号或11号立体定位真空辅助乳腺活检时诊断为ADH。123例患者中有26例（21.1%）升级为导管原位癌或浸润性癌。9号真空辅助乳腺活检的ADH发生率为600例病变中的83例（13.8%），11号真空辅助乳腺活检为391例病变中的58例（14.8%）。9号升级率为74例病变中的16例（21.6%），11号真空辅助乳腺活检为49例病变中的10例（20.4%）。两种设备获取的芯针活检样本数量无显著差异（p = 0.40）。9号和11号真空辅助乳腺活检的ADH发生率（p = 0.66）及升级率（p = 0.87）均无显著差异。