Plaza Michael J, Kumar Aswin V, Sanchez-Gonzalez Marcos A
Diagnostic Center for Women, Department of Breast Imaging and Intervention, LLC, Miami, FL.
Larkin Community Hospital, Department of Radiology, Miami, FL.
J Breast Imaging. 2019 Dec 5;1(4):324-328. doi: 10.1093/jbi/wbz047.
The purpose of this study is to evaluate the safety and efficacy of cryoablation for benign breast fibroepithelial lesions (FELs) that otherwise warrant surgical excision, including symptomatic fibroadenomas, growing fibroadenomas, and cellular FELs.
All patients from 2016-2018 who had ultrasound-guided cryoablation of a symptomatic and/or growing fibroadenoma or cellular fibroepithelial lesion were reviewed. The electronic medical record was reviewed for any procedure-related complications and reduction in mass volume by ultrasound and was recorded to assess for efficacy. Patients were surveyed using a seven-point Likert scale to assess satisfaction with the procedure and a ten-point visual analog pain scale to assess level of discomfort.
Twenty-four women (average age 37.1 years, range 19-57 years) with 26 FELs were treated with no adverse events and 100% technical success. Thirteen cellular FELs and 13 symptomatic and/or growing fibroadenomas were ablated. Twenty-two patients had an average imaging follow-up of 11.7 months (range 5-23 months), and 18 patients completed the follow-up survey. There was 92% (22/24) clinical success, defined as a greater-than-50% reduction in mass volume. Average reduction in mass volume was 86% overall. Eighty-five percent (17/20) would recommend the procedure to others and reported pain during the procedure to be minimal (average 2.4 out of 10) with overall satisfaction rating of 6.2 out of 7. Twelve symptomatic masses demonstrated a significant reduction in pain after cryoablation (P = 0.01).
Cryoablation is a safe and efficacious minimally invasive nonsurgical alternative for the treatment of benign breast FELs.
本研究旨在评估冷冻消融术对原本需要手术切除的乳腺良性纤维上皮性病变(FELs)的安全性和有效性,这些病变包括有症状的纤维腺瘤、生长中的纤维腺瘤以及细胞性FELs。
回顾了2016年至2018年所有接受超声引导下冷冻消融术治疗有症状和/或生长中的纤维腺瘤或细胞性纤维上皮性病变的患者。查阅电子病历,了解任何与手术相关的并发症以及通过超声测量的肿块体积缩小情况,并记录下来以评估疗效。使用七点李克特量表对患者进行调查,以评估对手术的满意度,使用十点视觉模拟疼痛量表评估不适程度。
24名女性(平均年龄37.1岁,范围19 - 57岁)的26个FELs接受了治疗,无不良事件发生,技术成功率达100%。消融了13个细胞性FELs和13个有症状和/或生长中的纤维腺瘤。22名患者的平均影像学随访时间为11.7个月(范围5 - 23个月),18名患者完成了随访调查。临床成功率为92%(22/二十四),定义为肿块体积缩小超过50%。总体肿块体积平均缩小85%。85%(17/二十)的患者会向他人推荐该手术,并报告手术过程中的疼痛最小(平均10分制中的2.4分),总体满意度评分为7分制中的6.2分。12个有症状的肿块在冷冻消融术后疼痛明显减轻(P = 0.01)。
冷冻消融术是治疗乳腺良性FELs的一种安全、有效的微创非手术替代方法。