Choi E-Ryung, Han Boo-Kyung, Ko Eun Sook, Ko Eun Young, Choi Ji Soo, Cho Eun Yoon, Nam Seok Jin
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
PLoS One. 2015 Dec 2;10(12):e0144046. doi: 10.1371/journal.pone.0144046. eCollection 2015.
To determine the imaging characteristic of frequent target lesions of wireless ultrasound (US)-guided, vacuum-assisted breast biopsy (Wi-UVAB) and to evaluate diagnostic yield, accuracy and complication of the device in indeterminate breast lesions.
From March 2013 to October 2014, 114 women (age range, 29-76 years; mean age, 50.0 years) underwent Wi-UVAB using a 13-gauge needle (Mammotome Elite®; Devicor Medical Products, Cincinnati, OH, USA). In 103 lesions of 96 women with surgical (n = 81) or follow-up (n = 22) data, complications, biopsy procedure, imaging findings of biopsy targets and histologic results were reviewed.
Mean number of biopsy cores was 10 (range 4-25). Nine patients developed moderate bleeding. All lesions were suspicious on US, and included non-mass lesions (67.0%) and mass lesions (33.0%). Visible calcifications on US were evident in 57.3% of the target lesions. Most of the lesions (93.2%) were nonpalpable. Sixty-six (64.1%) were malignant [ductal carcinoma in situ (DCIS) rate, 61%] and 12 were high-risk lesions (11.7%). Histologic underestimation was identified in 11 of 40 (27.5%). DCIS cases and in 3 of 9 (33.3%) high-risk lesions necessitating surgery. There was no false-negative case.
Wi-UVAB is very handy and advantageous for US-unapparent non-mass lesions to diagnose DCIS, especially for calcification cases. Histologic underestimation is unavoidable; still, Wi-UVAB is safe and accurate to diagnose a malignancy.
确定无线超声(US)引导下真空辅助乳腺活检(Wi-UVAB)常见靶病变的影像学特征,并评估该设备对不确定乳腺病变的诊断率、准确性及并发症。
2013年3月至2014年10月,114名女性(年龄范围29 - 76岁;平均年龄50.0岁)使用13号针(Mammotome Elite®;美国俄亥俄州辛辛那提市Devicor Medical Products公司)接受Wi-UVAB。对96名女性的103个病变进行回顾,这些病变有手术(n = 81)或随访(n = 22)数据,包括并发症、活检过程、活检靶的影像学表现及组织学结果。
活检核心平均数量为10个(范围4 - 25个)。9名患者出现中度出血。所有病变在超声上均为可疑病变,包括非肿块病变(67.0%)和肿块病变(33.0%)。57.3%的靶病变在超声上可见钙化。大多数病变(93.2%)不可触及。66个(64.1%)为恶性[原位导管癌(DCIS)率为61%],12个为高危病变(11.7%)。40个DCIS病例中有11个(27.5%)及9个高危病变中有3个(33.3%)需要手术的病例存在组织学低估。无假阴性病例。
Wi-UVAB对于超声不可见的非肿块病变诊断DCIS非常方便且具有优势,尤其是钙化病例。组织学低估不可避免;尽管如此,Wi-UVAB诊断恶性肿瘤安全且准确。