Cho Nariya, Moon Woo Kyung, Cha Joo Hee, Kim Sun Mi, Jang Mijung, Chang Jung Min, Chung Se Yeong
Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
Acta Radiol. 2009 Jul;50(6):602-9. doi: 10.1080/02841850902933107.
Microcalcifications detected at screening mammography are frequently diagnosed by means of a stereotactic biopsy. Ultrasound (US)-guided percutaneous breast biopsy has several advantages over stereotactic biopsy, e.g., it offers real-time needle visualization, improves patient comfort, the procedure time is generally considered to be shorter, and it usually does not require ionizing radiation or dedicated equipment.
To assess the frequency of calcification retrieval and factors affecting retrieval success for US-guided 11-G vacuum-assisted biopsies of microcalcifications.
Seventy-five consecutive women (age range: 25-68 years, mean age: 47 years) with 75 lesions of microcalcifications detected at screening mammography underwent US-guided 11-G vacuum-assisted biopsy. Calcification retrieval was defined as being successful when calcifications were detected in radiographs of specimens. Mammographic, ultrasonographic, and histologic findings were analyzed to identify factors that affected calcification retrieval.
Among 75 lesions that had US-guided vacuum-assisted biopsy, calcifications were retrieved in 53 (71%) lesions. Calcification retrieval was more frequent for lesions; associated with masses or dilated ducts at US (85% [41/48] vs. 44% [12/27], P<0.001), located in the anterior or middle part of the breast vs. posterior part of the breast (81% [47/58] vs. 35% [6/17], P=0.001), of maximal diameter more than 10 mm (82% [41/50] vs. 48% [12/25], P=0.002), with a segmental or regional distribution vs. clustered distribution (95% [18/19] vs. 63% [35/56], P=0.008), or lesions of category 4c or 5 vs. category 4a or 4b (100% [8/8] vs. 67% [45/67], P=0.054) at mammography.
US-guided 11-G vacuum-assisted biopsy retrieved calcifications from 71% (53/75) of lesions. Successful calcification retrieval was found to be related to the visibility of associated masses or dilated ducts by US, and to lesion depth, size, and distribution, and level of suspicion at mammography.
在乳腺钼靶筛查中发现的微钙化灶常通过立体定向活检进行诊断。超声（US）引导下经皮乳腺活检相较于立体定向活检具有多种优势，例如，它能实时显示穿刺针，提高患者舒适度，一般认为操作时间更短，且通常无需电离辐射或专用设备。
评估超声引导下11G真空辅助活检微钙化灶时钙化灶获取的频率及影响获取成功的因素。
75例在乳腺钼靶筛查中发现有75个微钙化灶病变的连续女性患者（年龄范围：25 - 68岁，平均年龄：47岁）接受了超声引导下11G真空辅助活检。当在标本射线照片中检测到钙化灶时，钙化灶获取被定义为成功。对乳腺钼靶、超声和组织学检查结果进行分析，以确定影响钙化灶获取的因素。
在75个接受超声引导真空辅助活检的病变中，53个（71%）病变的钙化灶被成功获取。对于与超声检查时的肿块或扩张导管相关的病变（85% [41/48] 对44% [12/27]，P < 0.001）、位于乳腺前部或中部而非后部的病变（81% [47/58] 对35% [6/17]，P = 0.001）、最大直径大于10 mm的病变（82% [41/50] 对48% [12/25]，P = 0.002）、呈节段性或区域性分布而非簇状分布的病变（95% [18/19] 对63% [35/56]，P = 0.008），以及乳腺钼靶检查中4c或5类病变而非4a或4b类病变（100% [8/8] 对67% [45/67]，P = 0.054），钙化灶获取更为频繁。
超声引导下11G真空辅助活检从71%（53/75）的病变中获取了钙化灶。发现钙化灶获取成功与超声检查时相关肿块或扩张导管的可见性、病变深度、大小、分布以及乳腺钼靶检查的可疑程度有关。
