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麦默通活检在乳腺导管内乳头状瘤诊断与治疗中的应用

Mammotome biopsy in diagnosing and treatment of intraductal papilloma of the breast.

作者信息

Kibil Wojciech, Hodorowicz-Zaniewska Diana, Popiela Tadeusz J, Szpor Joanna, Kulig Jan

出版信息

Pol Przegl Chir. 2013 Apr;85(4):210-5. doi: 10.2478/pjs-2013-0032.

Abstract

UNLABELLED

Intraductal papilloma is a benign breast tumor which needs histopathological verification because of the risk of cancer coincidence.

THE AIM OF THE STUDY

To assess the value of the mammography-guided and ultrasound-guided vacuum-assisted core biopsy in the diagnosis and treatment of intraductal papillomas of breast and to answer the question if mammotome biopsy allows to avoid surgery in these patients.

MATERIAL AND METHODS

In the period 2000-2011, a total of 2246 vacuum-assisted core biopsies were performed, of which 1495 were ultrasound-guided and 751 were mammography-guided (stereotaxic). In 76/2246 patients (3.4%), aged 19-88 years (mean age was 51,5) histopathological examination confirmed intraductal papilloma.

RESULTS

Atypical lesions were accompanying intraductal papilloma in 16/76 cases (21%). Open surgical biopsy performed in these group revealed invasive cancer in 3 women. In all 60 cases (79%) with benign papilloma in biopsy specimens, further clinical observation did not show recurrence or malignant transformation of lesions.

CONCLUSIONS

Vacuum-assisted core biopsy is a minimally invasive and efficient method used for diagnosing intraductal papilloma of the breast. If histopathological examination confirms a benign character of the lesion, surgery may be avoided but regular follow-up is recommended. However, in all cases histopathological diagnosis of papilloma with atypical hyperplasia, should always be indication for surgical excision.

摘要

未标注

导管内乳头状瘤是一种良性乳腺肿瘤,由于存在合并癌症的风险,需要进行组织病理学验证。

研究目的

评估乳腺X线引导和超声引导下真空辅助穿刺活检在乳腺导管内乳头状瘤诊断和治疗中的价值,并回答麦默通活检是否能使这些患者避免手术的问题。

材料与方法

在2000年至2011年期间,共进行了2246例真空辅助穿刺活检,其中1495例为超声引导,751例为乳腺X线引导(立体定位)。在76/2246例患者(3.4%)中,年龄19 - 88岁(平均年龄51.5岁),组织病理学检查确诊为导管内乳头状瘤。

结果

16/76例(21%)导管内乳头状瘤伴有非典型病变。对这组患者进行的开放手术活检显示3名女性患有浸润性癌。在活检标本中所有60例(79%)为良性乳头状瘤的病例中,进一步的临床观察未显示病变复发或恶变。

结论

真空辅助穿刺活检是诊断乳腺导管内乳头状瘤的一种微创且有效的方法。如果组织病理学检查证实病变为良性,则可避免手术,但建议定期随访。然而,在所有乳头状瘤伴非典型增生的组织病理学诊断病例中,手术切除始终应作为指征。

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