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影像引导下真空辅助乳腺活检在乳腺微钙化诊断中的应用

Image-guided vacuum-assisted breast biopsy in the diagnosis of breast microcalcifications.

作者信息

Liu Jun, Huang Linping

机构信息

Breast Center, China-Japan Friendship Hospital, Beijing, China.

出版信息

J Int Med Res. 2018 Jul;46(7):2743-2753. doi: 10.1177/0300060518770577. Epub 2018 May 17.

Abstract

Objective The present study was performed to assess the accuracy and clinical value of image-guided vacuum-assisted breast biopsy in the diagnosis of mammography-detected breast microcalcifications. Methods This prospective study involved 100 patients with suspicious mammography-detected microcalcifications who underwent image-guided vacuum-assisted breast biopsies from January 2013 to October 2016. Stereotactic vacuum-assisted breast biopsy (SVAB) was performed in 64 patients, and ultrasound (US)-guided vacuum-assisted breast biopsy (US-VAB) was performed in 36 patients in whom application of SVAB was difficult. The microcalcifications were detectable by mammography or US. The mean follow-up duration was 32 months (range, 9-57 months). The biopsy results were correlated with the pathological examination results. Results The positive predictive value of microcalcifications detected by mammography and US in the diagnosis of breast cancer was 37.0% (37/100) and 52.8% (19/36), respectively. The negative predictive value of microcalcifications detected by US in the diagnosis of breast cancer was 71.9% (46/64). No recurrence was observed in the 37 patients with breast cancer. No evidence of malignancy was found among the 63 patients with benign lesions. Conclusion Image-guided vacuum-assisted breast biopsy is accurate and minimally invasive. It can be used as a safe approach for diagnosis in patients with breast microcalcifications.

摘要

目的 本研究旨在评估影像引导下真空辅助乳腺活检在乳腺钼靶检测到的乳腺微钙化诊断中的准确性及临床价值。方法 本前瞻性研究纳入了100例乳腺钼靶检测到可疑微钙化的患者,这些患者在2013年1月至2016年10月期间接受了影像引导下真空辅助乳腺活检。64例患者接受了立体定向真空辅助乳腺活检(SVAB),36例难以应用SVAB的患者接受了超声(US)引导下真空辅助乳腺活检(US-VAB)。微钙化可通过乳腺钼靶或超声检测到。平均随访时间为32个月(范围9 - 57个月)。活检结果与病理检查结果进行相关性分析。结果 乳腺钼靶和超声检测到的微钙化在乳腺癌诊断中的阳性预测值分别为37.0%(37/100)和52.8%(19/36)。超声检测到的微钙化在乳腺癌诊断中的阴性预测值为71.9%(46/64)。37例乳腺癌患者均未复发。63例良性病变患者未发现恶性证据。结论 影像引导下真空辅助乳腺活检准确且微创。它可作为乳腺微钙化患者诊断的一种安全方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/266a/6124280/989c42525efe/10.1177_0300060518770577-fig1.jpg

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