Krekel Nicole M A, van Amerongen Annette H M Taets, Bergers Elisabeth, Meijer Sybren, van den Tol Petrousjka
VUmc, Amsterdam, Afd. Chirurgische oncologie, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(10):A4173.
Breast-conserving surgery for palpable mammary tumours is usually guided by palpation. It appears, however, that identifying tumour margins only by palpation can be problematic, resulting in less than optimal effectiveness of this type of operation. The use of ultrasonography is a simple and non-invasive way of facilitating real-time localisation of breast carcinoma during surgery so that a tumour can be excised with controlled precision. Ultrasound is used to localise the tumour prior to surgery; its location is subsequently marked on the skin. During tissue dissection, ultrasound can be used to inspect the location and depth of the tumour as well as determining whether the tumour's surrounding margins are sufficient, thereby preventing the unnecessary removal of healthy tissue. Ultrasound can be used again after the excision to verify that the tumour was indeed radically removed. The efficacy of ultrasonically guided surgery for palpable mammary tumours is currently being studied in a prospective, randomised, multicentre trial.
对于可触及的乳腺肿瘤,保乳手术通常由触诊引导。然而,似乎仅通过触诊来确定肿瘤边缘可能存在问题,导致这类手术的效果不尽人意。超声检查的应用是一种简单且非侵入性的方法,有助于在手术期间对乳腺癌进行实时定位,从而能够精确切除肿瘤。术前使用超声对肿瘤进行定位,随后在皮肤上标记其位置。在组织解剖过程中,超声可用于检查肿瘤的位置和深度,以及确定肿瘤周围边缘是否足够,从而避免不必要地切除健康组织。切除术后还可再次使用超声以确认肿瘤确实已被彻底切除。目前正在一项前瞻性、随机、多中心试验中研究超声引导手术对可触及乳腺肿瘤的疗效。