Salmon R J, Mirlesse V, Le Gal M, Durand J C
Service de Chirurgie, Institut Curie, Paris.
J Gynecol Obstet Biol Reprod (Paris). 1990;19(3):333-6.
In 1986 and 1987, 224 patients were operated on for microcalcification without palpable lesions of the breast. Classical orthogonal (perpendicular grid) localisation was performed in 123 patients: external cutaneous localisation of the nipple was performed in 78 patients and hook localisation in 25 patients. Primary excision without the need for re-excision was possible respectively in 88% and 94% with external and hook localisation and in 83% after orthogonal localisation. The mean volume of the operation specimen was lower after hook (38.3 cm3) than after cutaneous or orthogonal localisation (54.6 cm3). 43% of the patients had a malignant lesion and even when the cluster of microcalcifications was single 50% of the margins were positive. Pre-operative localisation of occult breast lesions has simplified the surgical technique of excision. Nevertheless the pre-operative diagnosis of malignancy should be improved on in order to perform a procedure both diagnostic and therapeutic in the same operation.
1986年和1987年,224例患者因乳腺微钙化但未触及病变而接受手术。123例患者采用经典正交(垂直网格)定位:78例患者进行乳头皮肤外定位,25例患者进行钩状定位。采用皮肤外定位和钩状定位的患者分别有88%和94%无需再次切除即可进行初次切除,采用正交定位后这一比例为83%。钩状定位后手术标本的平均体积(38.3立方厘米)低于皮肤或正交定位后(54.6立方厘米)。43%的患者存在恶性病变,即使微钙化簇为单个,50%的切缘仍为阳性。隐匿性乳腺病变的术前定位简化了切除手术技术。然而,术前恶性肿瘤的诊断仍需改进,以便在同一手术中进行兼具诊断和治疗作用的操作。