Gallagher W J, Cardenosa G, Rubens J R, McCarthy K A, Kopans D B
Department of Surgery, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston 02114.
AJR Am J Roentgenol. 1989 Nov;153(5):957-61. doi: 10.2214/ajr.153.5.957.
To explore the value of accurate preoperative localization of occult breast lesions, we reviewed 100 consecutive needle-directed breast biopsies performed by the same surgeon over a 1-year period. A spring hookwire device for localization was inserted parallel to the chest wall. Two thirds of biopsies were performed under local anesthesia, and all were performed in an outpatient setting. Sixteen lesions were invasive carcinomas, and eight were ductal carcinomas in situ. In 96 lesions, the localizing wire was placed within 2 mm of the lesion, and in the remaining four it was within 5 mm of the abnormality. The mammographic lesion was excised in the first specimen in 96 cases. One patient required a second biopsy because of failure to excise the lesion in question after three specimens were taken. The only surgical complication was one hematoma, which resolved within 3 months. Median specimen volume for the entire series was 6.0 cm3. Median largest specimen diameter was 2.5 cm. Precise preoperative localization with a spring hookwire to within 2 mm of the mammographic lesion allows the surgeon to excise a median volume of 6 cm3 breast tissue with consistent retrieval of the lesion.
为探讨隐匿性乳腺病变术前精确定位的价值，我们回顾了同一位外科医生在1年时间内连续进行的100例针引导乳腺活检。使用弹簧式定位导丝装置平行于胸壁插入。三分之二的活检在局部麻醉下进行，所有活检均在门诊完成。16例病变为浸润性癌，8例为导管原位癌。96例病变中，定位导丝放置在距病变2毫米以内，其余4例在距异常5毫米以内。96例患者的乳腺X线摄影显示的病变在第一个标本中被切除。1例患者在取了3个标本后仍未能切除相关病变，因此需要再次活检。唯一的手术并发症是1例血肿，在3个月内自行消退。整个系列的标本中位数体积为6.0立方厘米。最大标本直径中位数为2.5厘米。使用弹簧式定位导丝将乳腺X线摄影显示的病变精确术前定位在2毫米以内，可使外科医生切除中位数体积为6立方厘米的乳腺组织，并能持续找到病变。
