State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, China.
Ann Surg Oncol. 2011 Jan;18(1):109-13. doi: 10.1245/s10434-010-1207-9. Epub 2010 Aug 3.
Wire localization (WL) is traditionally performed before excisional biopsy for patients with nonpalpable breast lesions, but it has several disadvantages. Our current study examines whether the method of radiocolloid combined with methylene dye localization (RCML) has an advantage over WL.
From August 2006 to May 2009, 157 patients with nonpalpable breast lesions classified as BI-RADS category 5 were enrolled in our study. Of the 157 patients, 78 were assigned to WL and 79 to RCML. The status of surgical margins, weight of specimens, length of incisions, and duration of operation were compared between these two groups.
All patients were diagnosed after first excisional biopsy. The patients with malignancy accounted for 55.1% in WL group, and 53.2% in RCML group. For malignant lesions, fewer patients undergoing RCML had close or involved surgical margins than did those who had WL (19.0% vs. 39.5%, P = .038). The mean weight of specimen was 45.2 g in WL group and 39.0 g in RCML group (P < .001). The mean length of incision was 44.8 mm in WL group and 36.3 mm in RCML group (P < .001). The mean time of operation was 16.3 min for WL and 14.7 min for RCML (P = .001).
RCML provides precise identification of the site of the nonpalpable lesion and a visible marker to the lesion for surgeons and allows rapid, easy, and accurate excision of nonpalpable breast lesions. Therefore, RCML is a promising alternative to WL.
传统上,对于触诊阴性的乳腺病变患者,在进行切除活检前会进行导丝定位(WL),但它有几个缺点。我们目前的研究旨在检验放射性胶体联合亚甲蓝定位(RCML)的方法是否优于 WL。
2006 年 8 月至 2009 年 5 月,我们纳入了 157 例触诊阴性的乳腺病变患者,这些患者的 BI-RADS 分类为 5 类。其中,78 例患者被分配到 WL 组,79 例患者被分配到 RCML 组。我们比较了两组患者的手术切缘状态、标本重量、切口长度和手术时间。
所有患者均在首次切除活检后得到诊断。在 WL 组中,恶性病变患者占 55.1%,在 RCML 组中占 53.2%。对于恶性病变,RCML 组中手术切缘接近或受累的患者比例低于 WL 组(19.0% vs. 39.5%,P =.038)。WL 组的标本平均重量为 45.2 g,RCML 组的标本平均重量为 39.0 g(P <.001)。WL 组的切口平均长度为 44.8 mm,RCML 组的切口平均长度为 36.3 mm(P <.001)。WL 组的手术时间平均为 16.3 分钟,RCML 组的手术时间平均为 14.7 分钟(P =.001)。
RCML 为触诊阴性的乳腺病变提供了病变部位的精确标识和可见的病变标记,使外科医生能够快速、轻松、准确地切除触诊阴性的乳腺病变。因此,RCML 是 WL 的一种很有前途的替代方法。