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超声引导下无电缆13号真空辅助乳腺非肿块性病变活检

Ultrasound-guided cable-free 13-gauge vacuum-assisted biopsy of non-mass breast lesions.

作者信息

Seo Jiwoon, Kim Sun Mi, Jang Mijung, Yun Bo La, Lee Soo Hyun, Kim Eun-Kyu, Kang Eunyoung, Park So Yeon, Moon Woo Kyung, Choi Hye Young, Kim Bohyoung

机构信息

Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.

出版信息

PLoS One. 2017 Jun 19;12(6):e0179182. doi: 10.1371/journal.pone.0179182. eCollection 2017.

Abstract

PURPOSE

To compare the outcomes of ultrasound-guided core biopsy for non-mass breast lesions by the novel 13-gauge cable-free vacuum-assisted biopsy (VAB) and by the conventional 14-gauge semi-automated core needle biopsy (CCNB).

MATERIALS AND METHODS

Our institutional review board approved this prospective study, and all patients provided written informed consent. Among 1840 ultrasound-guided percutaneous biopsies performed from August 2013 to December 2014, 145 non-mass breast lesions with suspicious microcalcifications on mammography or corresponding magnetic resonance imaging finding were subjected to 13-gauge VAB or 14-gauge CCNB. We evaluated the technical success rates, average specimen numbers, and tissue sampling time. We also compared the results of percutaneous biopsy and final surgical pathologic diagnosis to analyze the rates of diagnostic upgrade or downgrade.

RESULTS

Ultrasound-guided VAB successfully targeted and sampled all lesions, whereas CCNB failed to demonstrate calcification in four (10.3%) breast lesions with microcalcification on specimen mammography. The mean sampling time were 238.6 and 170.6 seconds for VAB and CCNB, respectively. No major complications were observed with either method. Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) lesions were more frequently upgraded after CCNB (8/23 and 3/5, respectively) than after VAB (2/26 and 0/4, respectively P = 0.028).

CONCLUSION

Non-mass breast lesions were successfully and accurately biopsied using cable-free VAB. The underestimation rate of ultrasound-detected non-mass lesion was significantly lower with VAB than with CCNB.

TRIAL REGISTRATION

CRiS KCT0002267.

摘要

目的

比较采用新型13号无电缆真空辅助活检(VAB)和传统14号半自动粗针活检(CCNB)对非肿块型乳腺病变进行超声引导下粗针活检的结果。

材料与方法

我们的机构审查委员会批准了这项前瞻性研究,所有患者均提供了书面知情同意书。在2013年8月至2014年12月期间进行的1840例超声引导下经皮活检中,对145例在乳腺X线摄影中发现可疑微钙化或相应磁共振成像结果的非肿块型乳腺病变进行了13号VAB或14号CCNB。我们评估了技术成功率、平均标本数量和组织采样时间。我们还比较了经皮活检结果与最终手术病理诊断结果,以分析诊断升级或降级的发生率。

结果

超声引导下VAB成功对所有病变进行了靶向采样,而CCNB在4例(10.3%)乳腺X线摄影显示微钙化的乳腺病变标本中未能显示钙化。VAB和CCNB的平均采样时间分别为238.6秒和170.6秒。两种方法均未观察到严重并发症。CCNB后导管原位癌(DCIS)和非典型导管增生(ADH)病变的升级频率(分别为8/23和3/5)高于VAB后(分别为2/26和0/4,P = 0.028)。

结论

使用无电缆VAB成功且准确地对非肿块型乳腺病变进行了活检。VAB检测超声发现的非肿块病变的低估率显著低于CCNB。

试验注册

CRiS KCT0002267。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61ff/5476256/1fd1fa153ab3/pone.0179182.g001.jpg

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