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超声引导下手持式真空辅助乳腺粗针活检(VACB)在乳腺结节手术管理中的作用:KCCC经验的初步报告

The role of US guided handheld vacuum assisted breast core biopsy (VACB) in the surgical management of breast nodules: preliminary report of KCCC experience.

作者信息

Boarki K, Labib M

机构信息

Department of Radiology, Kuwait Cancer Control Centre.

出版信息

Gulf J Oncolog. 2008 Jul(4):39-44.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the role of US guided hand held vacuum-assisted breast core biopsy (VACB) in the surgical management of breast nodules.

MATERIALS AND METHODS

Twenty five breast nodules in twenty five women were subjected to US guided 11-gauge vacuum-assisted breast core biopsy over a period 22 months. Biopsies were performed using handheld 11-g VACB needle under US guidance using high-resolution US equipment with a 7.5-10 MHz linear transducer. A median of 12 specimens were obtained per lesion with insertion of a clip marker in place. Pre and post procedure imaging findings, complications, histologic outcome, and medical records were reviewed.

RESULTS

The patient median age was 50.16 years (range, 36- 72 years). Lesion median size was 1.7 cm (range 0.8-3.0 cm). Lesions were categorized using BI-RAD system as follow: 12 (48%) category 3, 11 (44%) category 4 and 2 (8%) as category 5. Six out of 25 (24%) lesions were palpable. The median time required to perform the biopsy was 25 min (range, 20-40 min). Complete removal of the lesion seen at sonography was achieved in 22/25 lesions (88%) and was significantly more frequent in lesions measuring < 1.5 cm than in larger lesions. Accuracy was 100 %. No repeat was asked. Surgical biopsy was spared in 24/25 (96%) patients. One case was referred for surgical excision upon pathologist advice.

CONCLUSION

In our small series, US guided vacuum-assisted beast core biopsy was a fast, less invasive, accurate method in diagnosing breast nodules. It is a cost effective procedure, accepted by the patient and led to sparing surgical procedure in 96 % of women. VACB has become an integral part in the management of breast nodules and further work is going on to assess the long-term outcome.

摘要

目的

本研究旨在评估超声引导下手持式真空辅助乳腺粗针活检(VACB)在乳腺结节手术治疗中的作用。

材料与方法

在22个月的时间里,对25名女性的25个乳腺结节进行了超声引导下11号真空辅助乳腺粗针活检。活检采用手持式11号VACB针,在超声引导下使用配备7.5 - 10 MHz线性换能器的高分辨率超声设备进行。每个病灶平均获取12个标本,并放置一个夹式标记物。回顾了术前和术后的影像学表现、并发症、组织学结果及病历资料。

结果

患者的中位年龄为50.16岁(范围36 - 72岁)。病灶的中位大小为1.7 cm(范围0.8 - 3.0 cm)。根据BI - RAD系统对病灶进行分类如下:3类12个(48%),4类11个(44%),5类2个(8%)。25个病灶中有6个(24%)可触及。进行活检所需的中位时间为25分钟(范围20 - 40分钟)。25个病灶中有22个(88%)在超声检查中实现了病灶的完全切除,且直径<1.5 cm的病灶比更大的病灶更常实现完全切除。准确率为100%。无需重复活检。25名患者中有24名(96%)避免了手术活检。1例根据病理学家的建议接受了手术切除。

结论

在我们的小样本研究中,超声引导下真空辅助乳腺粗针活检是诊断乳腺结节的一种快速、微创且准确的方法。它是一种经济有效的检查方法,患者易于接受,96%的女性因此避免了手术。VACB已成为乳腺结节治疗中不可或缺的一部分,目前正在进一步开展工作以评估其长期效果。

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