Bennett Ian C, Saboo Apoorva
Breast and Endocrine Surgical Unit, Princess Alexandra Hospital, University of Queensland, Woolloongabba, Brisbane, QLD, Australia.
World J Surg. 2019 Apr;43(4):1054-1061. doi: 10.1007/s00268-018-04892-x.
The management of breast disease has been greatly facilitated by the technology of needle biopsy interventions, and over the past 30 years, this has evolved from the use of fine-needle aspiration biopsy (FNAB) to the current methodology of vacuum assisted biopsy (VAB).
This article provides an historical review of the application of needle interventions of the breast in the diagnosis and management of breast conditions, and discusses current indications for the use of vacuum assisted biopsies and vacuum assisted excisions.
Whilst FNAB continues to have a limited role in breast disease diagnosis, the necessity of achieving an histological diagnosis has preferentially seen the development and wider application of automated core needle biopsies (CNB) and VAB in the assessment and management of breast lesions. The advantages of CNB and VAB include the ability to distinguish in situ and invasive disease pre-operatively, and the ability to achieve prior knowledge of immunohistochemical tumour markers particularly in the setting of neoadjuvant drug treatments.
Due to its ability to obtain larger tissue samples, VAB does have diagnostic advantages over CNB and indications for the utilization of VAB are discussed. VAB additionally has an expanding role as a tool for breast lesion excision.
针吸活检技术极大地促进了乳腺疾病的管理，在过去30年里，这一技术已从细针穿刺抽吸活检（FNAB）发展到目前的真空辅助活检（VAB）方法。
本文对乳腺针吸活检在乳腺疾病诊断和管理中的应用进行了历史回顾，并讨论了当前真空辅助活检和真空辅助切除的应用指征。
虽然FNAB在乳腺疾病诊断中仍发挥着有限的作用，但由于需要获得组织学诊断，自动芯针活检（CNB）和VAB在乳腺病变评估和管理中的发展及更广泛应用成为优先选择。CNB和VAB的优势包括能够在术前区分原位癌和浸润性癌，以及能够提前了解免疫组化肿瘤标志物情况，特别是在新辅助药物治疗背景下。
由于VAB能够获取更大的组织样本，其在诊断方面确实比CNB具有优势，并对VAB的应用指征进行了讨论。此外，VAB作为乳腺病变切除工具的作用也在不断扩大。
