Vieira Sabas Carlos, Alves Viviane Carvalho, Oliveira Tayná Cristinne Barros de, Ibiapina Jacira Oliveira, Soares Emmyle Cristyne Alves, Crisanto Marcus Luciano Lopes de Paiva
Universidade Federal do Piauí, Department of General Practice, Teresina, Brazil.
Universidade Federal do Piauí, Teresina, Brazil, Medical Student, Universidade Federal do Piauí, Teresina, Brazil.
Sao Paulo Med J. 2014;132(1):10-4. doi: 10.1590/1516-3180.2014.1321559.
Use of mammography for breast cancer screening has resulted in a significantly increased number of patients with nonpalpable radiological findings that need histopathological study for better management. The present study evaluated an alternative to excision of nonpalpable breast lesions, using injection of patent blue (CAS 3536-49-0) dye and air.
Cohort study of 64 consecutive patients at a private clinic in the city of Teresina (Piauí), between January 2009 and December 2010.
The patients had received mammographic diagnoses of nonpalpable breast lesions classified as BI-RADS 3, 4 and 5, with indication of histopathological study. They underwent stereotaxy and/or ultrasound-guided injection of patent blue, for marking and subsequent excision of the lesion.
The patients' mean age was 47.7 years. Nodes accounted for 53.1% of the breast abnormalities; microcalcifications, 37.5%; and complex cysts, 9.4%. In 89.1% of cases, the lesions were BI-RADS 4; 7.8% were BI-RADS 5 and 3.1% were BI-RADS 3. The histopathological findings were benign in 70.3% of the cases; atypical hyperplasia, 9.4%; and malignant, 20.3%. Among the malignant cases, 53.8% were carcinoma in situ and 46.2%, invasive carcinoma. The percentage of malignancy was 0% in BI-RADS 3 lesions; 14.3% in BI-RADS 4 and 100% in BI-RADS 5. In the cases of malignancy, the margins were clear in 92.3%. Reoperation to widen the margins was required in one patient.
Excision of nonpalpable breast lesions marked with patent blue and air was possible in all cases.
使用乳房X线摄影术进行乳腺癌筛查，使得需要进行组织病理学研究以更好管理的不可触及的放射学检查结果的患者数量显著增加。本研究评估了一种替代不可触及乳腺病变切除术的方法，即注射专利蓝（CAS 3536-49-0）染料和空气。
2009年1月至2010年12月期间，在特雷西纳市（皮奥伊州）一家私人诊所对64例连续患者进行队列研究。
患者经乳房X线摄影诊断为不可触及的乳腺病变，分类为BI-RADS 3、4和5级，需要进行组织病理学研究。他们接受了立体定向和/或超声引导下的专利蓝注射，用于标记并随后切除病变。
患者的平均年龄为47.7岁。乳腺异常中，结节占53.1%；微钙化占37.5%；复杂囊肿占9.4%。在89.1%的病例中，病变为BI-RADS 4级；7.8%为BI-RADS 5级，3.1%为BI-RADS 3级。组织病理学结果显示，70.3%的病例为良性；非典型增生占9.4%；恶性占20.3%。在恶性病例中，53.8%为原位癌，46.2%为浸润性癌。BI-RADS 3级病变的恶性率为0%；BI-RADS 4级为14.3%，BI-RADS 5级为100%。在恶性病例中，92.3%的切缘清晰。1例患者需要再次手术以扩大切缘。
在所有病例中，均可以切除用专利蓝和空气标记的不可触及乳腺病变。
