Niinikoski Laura, Hukkinen Katja, Leidenius Marjut H K, Ståhls Anders, Meretoja Tuomo J
Breast Surgery Unit, Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, P.O. Box 263, 00029 HUS, Finland.
HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 263, 00029 HUS, Finland.
Eur J Surg Oncol. 2018 Jan;44(1):59-66. doi: 10.1016/j.ejso.2017.10.213. Epub 2017 Nov 14.
This study aims to evaluate the feasibility of Breast Lesion Excision System (BLES) in the treatment of intraductal papillomas.
All patients with a needle biopsy -based suspicion of an intraductal papilloma who consequently underwent a BLES procedure at Helsinki University Hospital between 2011 and 2016 were included in this retrospective study. The purpose of the BLES procedure was either to excise the entire lesion or in few cases to achieve better sampling.
In total, 74 patients underwent 80 BLES procedures. Pathological diagnosis after the BLES biopsy confirmed an intraductal papilloma without atypia in 43 lesions, whereas 10 lesions were upgraded to high-risk lesions (HRL) with either atypical ductal hyperplasia or lobular carcinoma in situ. Five cases were upgraded to malignancy, two were invasive ductal carcinomas and three were ductal carcinoma in situ. Additionally, 18 lesions were diagnosed as other benign lesions. Four procedures failed. Complete excision with BLES was achieved in 19 out of 43 intraductal papillomas, 6 out of 10 HRL and two out of five malignant lesions. No major complications occurred. The BLES procedure was adequate in the management of the 71 breast lesions.
The BLES procedure is an acceptable method for the management of small benign and high-risk breast lesions such as intraductal papillomas in selected patients. Thus, a great amount of diagnostic surgical biopsies can be avoided.
本研究旨在评估乳腺病变切除系统（BLES）治疗导管内乳头状瘤的可行性。
本回顾性研究纳入了2011年至2016年间在赫尔辛基大学医院因针吸活检怀疑为导管内乳头状瘤而接受BLES手术的所有患者。BLES手术的目的要么是切除整个病变，要么在少数情况下是为了获得更好的样本。
共有74例患者接受了80次BLES手术。BLES活检后的病理诊断证实43个病变为无异型性的导管内乳头状瘤，而10个病变升级为高危病变（HRL），伴有非典型导管增生或小叶原位癌。5例升级为恶性肿瘤，2例为浸润性导管癌，3例为导管原位癌。此外，18个病变被诊断为其他良性病变。4例手术失败。43个导管内乳头状瘤中有19个通过BLES实现了完整切除，10个HRL中有6个，5个恶性病变中有2个。未发生重大并发症。BLES手术对71个乳腺病变的处理是充分的。
对于选定患者中的小型良性和高危乳腺病变，如导管内乳头状瘤，BLES手术是一种可接受的治疗方法。因此，可以避免大量的诊断性手术活检。
