Division of Breast and Thyroid Surgery, Department of Surgery, Kangnam Cha Hospital, Cha University College of Medicine, Seoul, Korea.
J Breast Cancer. 2011 Mar;14(1):1-7. doi: 10.4048/jbc.2011.14.1.1. Epub 2011 Mar 31.
The gold standard for breast biopsy procedures is currently an open excision of the suspected lesion. However, an excisional biopsy inevitably makes a scar. The cost and morbidity associated with this procedure has prompted many physicians to evaluate less invasive, alternative procedures. More recently, image-guided percutaneous core-needle biopsy has become a frequently used method for diagnosing palpable and non-palpable breast lesions. Although sensitivity rates for core-needle biopsy are high, it has the disadvantage of histological underestimation, which renders the management of atypical ductal hyperplasia, papillary lesions, and fibroepithelial lesions somewhat difficult. Vacuum assisted breast biopsy (VABB) was developed to overcome some of these negative aspects of core-needle biopsy. VABB allows for a sufficient specimen to be obtained with a single insertion and can provide a more accurate diagnosis and completely remove the lesion under real-time ultrasonic guidance. The advantage of complete lesion removal with VABB is to reduce or eliminate sampling error, to decrease the likelihood of a histological underestimation, to decrease imaging-histological discordance, to decrease the re-biopsy rate, and to diminish the likelihood of subsequent growth on follow-up. In recent years, with the advancement of VABB instruments and techniques, many outcome studies have reported on the use of VABB for resecting benign breast lesions with a curative intent. VABB is highly accurate for diagnosing suspicious breast lesions and is highly successful at treating presumed benign breast lesions. Thus, in the near future, VABB will be routinely offered to all appropriately selected patients.
目前，乳腺活检的金标准是对可疑病变进行开放性切除。然而，切除活检不可避免地会留下疤痕。这种手术相关的费用和发病率促使许多医生评估侵袭性更小的替代方法。最近，影像引导下经皮空心针活检已成为诊断可触及和不可触及乳腺病变的常用方法。虽然空心针活检的敏感性很高，但它有组织学低估的缺点，这使得对非典型导管增生、乳头状病变和纤维上皮病变的处理有些困难。真空辅助乳腺活检（VABB）的开发是为了克服空心针活检的一些负面问题。VABB 允许通过单次插入获得足够的标本，并且可以在实时超声引导下提供更准确的诊断并完全切除病变。VABB 完全切除病变的优点是减少或消除取样误差，降低组织学低估的可能性，减少影像学-组织学不匹配，降低再次活检的可能性，并减少随访中后续生长的可能性。近年来，随着 VABB 仪器和技术的进步，许多研究报告了使用 VABB 切除有治愈意图的良性乳腺病变。VABB 对诊断可疑乳腺病变非常准确，对治疗疑似良性乳腺病变非常成功。因此，在不久的将来，VABB 将常规提供给所有适当选择的患者。
