Radiology Department, Hôpital Privé d'Antony, Antony, France.
Breast J. 2013 Jan-Feb;19(1):4-9. doi: 10.1111/tbj.12044. Epub 2012 Dec 17.
The purpose of this study was to describe our operating process and to report results of 118 stereotactic vacuum-assisted biopsies performed on a digital breast 3D-tomosynthesis system. From October 2009 to December 2010, 118 stereotactic vacuum assisted biopsies have been performed on a digital breast 3D-tomosynthesis system. Informed consent was obtained for all patients. A total of 106 patients had a lesion, six had two lesions. Sixty-one lesions were clusters of micro-calcifications, 54 were masses and three were architectural distortions. Patients were in lateral decubitus position to allow shortest skin-target approach (or sitting). Specific compression paddle, adapted on the system, performed, and graduated, allowing localization in X-Y. Tomosynthesis views define the depth of lesion. Graduated Coaxial localization kit determines the beginning of the biopsy window. Biopsies were performed with an ATEC-Suros, 9 Gauge handpiece. All biopsies, except one, have reached the lesions. Five hemorrhages were incurred in the process, but no interruption was needed. Eight breast hematomas, were all spontaneously resolved. One was an infection. About 40% of patients had a skin ecchymosis. Processing is fast, easy, and requires lower irradiation dose than with classical stereotactic biopsies. Histology analysis reported 45 benign clusters of micro-calcifications, 16 malignant clusters of micro-calcifications, 24 benign masses, and 33 malignant masses. Of 13 malignant lesions, digital 2D-mammography failed to detect eight lesions and underestimated the classification of five lesions. Digital breast 3D-tomosynthesis depicts malignant lesions not visualized on digital 2D-mammography. Development of tomosynthesis biopsy unit integrated to stereotactic system will permit histology analysis for suspicious lesions.
本研究旨在描述我们的操作流程，并报告在数字乳腺三维断层合成系统上进行的 118 例立体定向真空辅助活检的结果。2009 年 10 月至 2010 年 12 月，在数字乳腺三维断层合成系统上进行了 118 例立体定向真空辅助活检。所有患者均获得知情同意。共有 106 例患者有病变，6 例患者有 2 个病变。61 个病变为微钙化簇，54 个为肿块，3 个为结构扭曲。患者取侧卧位，以便于最短的皮肤-靶位入路（或坐位）。使用特定的适配于系统的压缩板进行 X-Y 定位，并进行分级。断层合成视图定义病变的深度。分级同轴定位套件确定活检窗的起始位置。使用 ATEC-Suros，9 号活检枪进行活检。除 1 例外，所有活检均到达病变部位。在操作过程中发生了 5 例出血，但无需中断。发生了 8 例乳腺血肿，均自行消退。1 例为感染。约 40%的患者皮肤有瘀斑。处理过程快速、简单，所需的照射剂量低于传统的立体定向活检。组织学分析报告了 45 例良性微钙化簇、16 例恶性微钙化簇、24 例良性肿块和 33 例恶性肿块。在 13 例恶性病变中，数字二维乳腺 X 线摄影未能检出 8 例病变，并低估了 5 例病变的分类。数字乳腺三维断层合成能够显示数字二维乳腺 X 线摄影无法显示的恶性病变。立体定向系统集成的断层合成活检单元的发展将允许对可疑病变进行组织学分析。
