Lee Kyoung Eun, Kim Hak Hee, Shin Hee Jung, Cha Joo Hee
Department of Radiology, Seoul Paik Hospital, Inje University, Seoul, 100-032 South Korea.
Springerplus. 2013 Oct 22;2:551. doi: 10.1186/2193-1801-2-551. eCollection 2013.
To evaluate efficacy of the stereotactic vacuum-assisted breast biopsy(SVAB) using a decubitus table and to compare histologic underestimation rate between 11gauge(G)- and 8G-probes.
Pathologic results of SVAB using a decubitus table of 210(120 with 11G; 90 with 8G)-procedures in 208-women(median age, 48.8 years; range, 27-73 years) were retrospectively reviewed. SVAB was performed for suspicious microcalcification without mass on MMG and US. Surgury was performed for the diagnosis of malignant or high-risk lesion (65(31.0%)). Patients with benign diagnosis (120(57.1%)) underwent MMG follow-up (mean, 340-days). Histologic underestimation was defined as the need to upgrade ADH to DCIS or IDC, and DCIS to IDC at surgery. We analyzed the difference of procedure time, core number and core weight between 11G- and 8G-groups. Statistical significance was determined with chi-square test and 95%-CI for histologic underestimation, and student T-test for comparing two-groups.
Targeting was successful in all 210-biopsies on specimen radiographs. Mean core number, core weight and procedure time were 17.5 (17.5 ± 4.9), 1.57 g (1.57 ± 0.56), 34.5 min (34.5 ± 16.4) with 11G-probe, and 9.6 (9.6 ± 6.2), 1.83g (1.83 ± 0.93), 22.1 min (22.1 ± 12.5) with 8G-probe. Findings in 120 (57.1%) of the biopsies were benign, 36 (17.2%) were high-risk, and 54 (25.7%) were malignant. Two (6.25%) of 32 cases of ADH were upgraded to DCIS in 11G-group, and 2 (9.09%) of 22 in 8G-group. No case of DCIS was upgraded to IDC. There was no increase of complication in 8G-group than 11G-group.
SVAB using a decubitus table is safe and effective method for the evaluation of suspicious microcalcification, and there was no significant difference between 11G- and 8G-probes. But, SVAB with 8G-probe is significantly more time efficient and effective procedure.
评估使用卧位检查台进行立体定向真空辅助乳腺活检(SVAB)的疗效,并比较11号(G)和8G探头的组织学低估率。
回顾性分析208名女性(中位年龄48.8岁;范围27 - 73岁)采用卧位检查台进行的210例(11G探头120例;8G探头90例)SVAB的病理结果。对乳腺钼靶(MMG)和超声检查发现的可疑微小钙化灶且无肿块的患者进行SVAB。对恶性或高危病变进行手术诊断(65例(31.0%))。诊断为良性的患者(120例(57.1%))接受MMG随访(平均340天)。组织学低估定义为手术时需要将非典型导管增生(ADH)升级为导管原位癌(DCIS)或浸润性导管癌(IDC),以及将DCIS升级为IDC。我们分析了11G组和8G组之间操作时间、芯条数和芯条重量的差异。采用卡方检验和95%置信区间分析组织学低估情况,采用学生t检验比较两组。
所有210例活检标本在X线片上靶向均成功。11G探头组的平均芯条数、芯条重量和操作时间分别为17.5(17.5±4.9)条、1.57 g(1.57±0.56)、34.5分钟(34.5±16.4);8G探头组分别为9.6(9.6±6.2)条、1.83g(1.83±0.93)、22.1分钟(22.1±12.5)。120例(57.1%)活检结果为良性,36例(17.2%)为高危,54例(25.7%)为恶性。11G组32例ADH中有2例(6.25%)升级为DCIS,8G组22例中有2例(9.09%)升级。没有DCIS升级为IDC的病例。8G组并发症发生率与11G组相比没有增加。
使用卧位检查台进行SVAB是评估可疑微小钙化灶的安全有效方法,11G和8G探头之间没有显著差异。但是,8G探头的SVAB操作时间效率更高且更有效。