Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Clin Radiol. 2012 Mar;67(3):244-9. doi: 10.1016/j.crad.2011.09.002. Epub 2011 Oct 19.
To assess the clinical impact of a new patient management pathway incorporating vacuum-assisted biopsy for lesions of uncertain malignant potential (B3).
A retrospective analysis was undertaken of all B3 lesions on core biopsy in the pathology database from April 2008 to April 2010. Outcome measures assessed included final histological diagnosis, frequency of diagnostic surgical biopsy, and impact on management.
In the old pathway, there were 95 B3 lesions, of which 14% (13/95) were planned for vacuum-assisted biopsy and 86% (82/95) for surgical biopsy. In the new pathway, there were 94 B3 lesions, of which 68% (64/94) were planned for vacuum-assisted biopsy and 32% (30/94) for surgical biopsy. Following further sampling with vacuum-assisted biopsy, only 13% of patients required diagnostic surgical biopsy and in 25% of cases, a preoperative diagnosis of carcinoma was reached allowing patients to proceed to therapeutic surgery.
The new pathway has reduced the number of benign diagnostic surgical biopsies performed and increased the preoperative diagnosis of breast cancer.
评估一种新的患者管理路径的临床影响，该路径纳入了真空辅助活检用于不确定恶性潜能的病变（B3）。
对 2008 年 4 月至 2010 年 4 月在病理数据库中所有核心活检的 B3 病变进行回顾性分析。评估的结果指标包括最终组织学诊断、诊断性外科活检的频率以及对管理的影响。
在旧路径中，有 95 个 B3 病变，其中 14%（13/95）计划进行真空辅助活检，86%（82/95）计划进行外科活检。在新路径中，有 94 个 B3 病变，其中 68%（64/94）计划进行真空辅助活检，32%（30/94）计划进行外科活检。在进行真空辅助活检进一步取样后，仅 13%的患者需要进行诊断性外科活检，在 25%的病例中，术前诊断为癌，使患者能够进行治疗性手术。
新路径减少了良性诊断性外科活检的数量，并增加了乳腺癌的术前诊断。
