Department of General Surgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Breast J. 2011 Sep-Oct;17(5):490-7. doi: 10.1111/j.1524-4741.2011.01125.x. Epub 2011 Jul 15.
The stereotactic or ultrasound-guided vacuum-assisted breast biopsy (Mammotome, MMT) system is a minimally invasive surgical technique. Increasingly, it is used to remove benign breast lesions as management. To evaluate the therapeutic value of 8-gauge ultrasound-guided MMT system (UMS) in presumed benign breast lesions, a retrospective analysis was performed on a series of 2,167 consecutive 8-gauge UMS procedures. The parameters used in this analysis included lesion size, location, breast imaging reporting and data system for ultrasound category, histopathologic diagnosis, and others. A total of 1,119 women whose mean ages were 36.6 years (range: 12-71, SD: 9.6) underwent 2,167 consecutive 8-gauge UMS procedures. Among the patients, 298 cases (26.63%) did not have palpable mass, 430 (38.43%) had multiple lesions, and 237 (21.18%) had bilateral ones. The average size of excised lesions was 15.8 mm (range: 5-55, SD: 6.7) in the largest dimension, including 294 lesions < 10 mm (13.57%); 1,359 lesions, 10-19 mm (62.71%); 420 lesions, 20-29 mm (19.38%), and 94 lesions ≥ 30 mm (4.34%). Predominant lesions (81.59%) were solid on ultrasound image and nearly half (48.59%) of them were localized in the upper outer quadrant. Histopathologic diagnosis revealed that the overwhelming majority of specimens (96.61%) were benign, most of which manifested as fibroadenoma and fibrocystic changes, while high-risk lesions were revealed in 31 (2.29%) cases and malignancies in 15 (1.11%). Average time for procedure was 8.6 minutes (range: 3.5-38, SD: 5.4) and mean number of cores removed in the procedure was 9.3 (range: 2-42, SD: 3.7). Complete excision was achieved predominantly (99.82%). Complications (59, 5.27%) in which hematoma (41, 3.66%) was the majority were acceptable. In conclusion, the 8-gauge UMS procedure is a safe and potent therapeutic management with satisfactory cosmetic outcome for benign and high-risk breast lesions, especially for bilateral, multiple, and nonpalpable ones. It is a reliable biopsy tool for suspected lesions as well. Eradication and maximal cosmesis can be achieved with few complications if the targeted lesion is limited to 30 mm.
在立体定向或超声引导下的真空辅助乳腺活检（Mammotome，MMT）系统是一种微创外科技术。越来越多地用于切除良性乳腺病变作为治疗手段。为了评估 8 号超声引导 MMT 系统（UMS）在疑似良性乳腺病变中的治疗价值，对一系列 2167 例 8 号 UMS 手术进行了回顾性分析。该分析中使用的参数包括病变大小、位置、乳腺影像报告和数据系统（BI-RADS-US）分类、组织病理学诊断等。共有 1119 名年龄在 12-71 岁之间、平均年龄为 36.6 岁（标准差：9.6）的女性接受了 2167 例连续的 8 号 UMS 手术。在这些患者中，298 例（26.63%）无可触及肿块，430 例（38.43%）有多个病变，237 例（21.18%）为双侧病变。切除病变的平均大小为 15.8 毫米（最大尺寸范围：5-55，标准差：6.7），包括 294 个＜10 毫米（13.57%）的病变；1359 个 10-19 毫米（62.71%）的病变；420 个 20-29 毫米（19.38%）的病变；94 个≥30 毫米（4.34%）的病变。超声图像上主要表现为实性病变（81.59%），近一半（48.59%）位于外上象限。组织病理学诊断显示，绝大多数标本（96.61%）为良性，其中大多数表现为纤维腺瘤和纤维囊性改变，而 31 例（2.29%）为高危病变，15 例（1.11%）为恶性肿瘤。手术平均时间为 8.6 分钟（范围：3.5-38，标准差：5.4），手术中切除的核心平均数量为 9.3 个（范围：2-42，标准差：3.7）。主要达到完全切除（99.82%）。并发症（59 例，5.27%）中，血肿（41 例，3.66%）占多数，是可以接受的。总之，8 号 UMS 手术是一种安全有效的治疗方法，对于良性和高危乳腺病变，特别是双侧、多发性和不可触及的病变，具有满意的美容效果。对于疑似病变也是一种可靠的活检工具。如果目标病变限于 30 毫米，可通过较少的并发症达到根治和最大的美容效果。
