乳腺错构瘤：超声引导下真空辅助乳腺活检对其治疗是否足够？
Mammary hamartoma: is ultrasound-guided vacuum-assisted breast biopsy sufficient for its treatment?
作者信息
Hu Huayu, Zhang Mengke, Liu Yuan, Li Xi-Ru, Liu Gang, Wang Zhili
机构信息
School of Medicine, Nankai University, Tianjin, China.
Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China.
出版信息
Gland Surg. 2020 Oct;9(5):1278-1285. doi: 10.21037/gs-20-437.
BACKGROUND
Mammary hamartomas were mostly benign tumors with rare rate of recurrence and malignant transformation. Ultrasound (US)-guided vacuum-assisted breast biopsy (VABB) has been reported sufficiently safe in treating many breast benign tumors but remained undefined in mammary hamartoma for its usual underdiagnosis in US. Thus, this study aims to evaluate the efficiency of US-guided VABB in treating mammary hamartomas.
METHODS
From May 2015 to March 2019, 3,388 lesions of 2,534 patients underwent percutaneous US-guided VABB, among which 31 mammary hamartomas proved by pathology were included in this study. Patients were followed up by US three, six and twelve months later, then at 1-year intervals. Lesions were classified to analyze the possible factors associated with excision rate, bleeding volume and complications.
RESULTS
Of the 31 patients, recurrence was seen in 1 case in 1 year after the procedure and complete excision rate was 96.8% (30/31). The bleeding volume ranged from 1 to 15 mL (mean number ± standard deviation, 6.5±3.4 mL) and significant statistical differences were detected in patient age and the largest diameter of lesions. The main complications included pain (22.6%), hematomas (9.7%) and ecchymosis (3.2%).
CONCLUSIONS
US-guided VABB ensures an outstanding complete excision rate and provides an alternative solution to treat mammary hamartomas.
背景
乳腺错构瘤大多为良性肿瘤，复发率和恶变率较低。超声（US）引导下真空辅助乳腺活检（VABB）已被报道在治疗多种乳腺良性肿瘤时足够安全，但在乳腺错构瘤中，由于其在超声检查中常被漏诊，其应用仍不明确。因此，本研究旨在评估超声引导下VABB治疗乳腺错构瘤的疗效。
方法
2015年5月至2019年3月，2534例患者的3388个病灶接受了经皮超声引导下VABB，其中31个经病理证实为乳腺错构瘤的病灶纳入本研究。术后3个月、6个月和12个月对患者进行超声随访，之后每年随访一次。对病灶进行分类，分析与切除率、出血量和并发症相关的可能因素。
结果
31例患者中，术后1年有1例复发，完全切除率为96.8%（30/31）。出血量为1至15 mL（平均数±标准差，6.5±3.4 mL），患者年龄和病灶最大直径存在显著统计学差异。主要并发症包括疼痛（22.6%）、血肿（9.7%）和瘀斑（3.2%）。
结论
超声引导下VABB可确保出色的完全切除率，并为治疗乳腺错构瘤提供了一种替代方案。
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