Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
J Breast Imaging. 2024 Sep 11;6(5):485-492. doi: 10.1093/jbi/wbae033.
Due to the superficial location, suspicious findings of the nipple-areolar complex (NAC) are not amenable to stereotactic or MRI-guided sampling and have historically necessitated surgical biopsy or skin-punch biopsy. There are limited reports of US-guided core biopsy of the nipple (US-CBN).
We report our nearly 3-year pilot experience with US-CBN at an academic breast imaging center.
An institutional review board-exempt and HIPAA-compliant retrospective review was performed. We assessed patient demographics, breast imaging characteristics, procedural data, pathology, and outcomes.
Nine female patients aged 27 to 64 underwent US-CBN from January 2021 to October 2023. Initial imaging abnormalities included abnormal MRI enhancement, mammographic calcifications, and sonographic masses. After initial or second-look US, all imaging findings had sonographic correlates for biopsy specimens, the majority of which were sonographic masses (8/9). US-CBN was performed by 6 breast radiologists using a variety of devices. All biopsy specimen results were concordant with sonographic abnormalities, although 1 was considered discordant from the initial abnormality seen on MRI. There were no complications, and discomfort during the procedure was well-treated. Two patients (22%, 2/9) were diagnosed with malignancy.
This pilot study demonstrated that US-CBN can be performed by a breast radiologist for definitive diagnosis of suspicious nipple abnormalities seen on breast imaging, avoiding surgery, and maintaining nipple integrity. In our population, 22% (2/9) of US-CBNs revealed malignancy.
由于乳晕乳头复合体（NAC）的位置较浅，不适合进行立体定向或 MRI 引导下的取样，因此历史上需要进行手术活检或皮肤穿刺活检。目前仅有有限的关于超声引导下乳晕核心活检（US-CBN）的报道。
我们报告了在学术性乳腺影像中心进行 US-CBN 的近 3 年的初步经验。
进行了一项机构审查委员会豁免和 HIPAA 合规的回顾性研究。我们评估了患者的人口统计学资料、乳腺影像学特征、操作数据、病理学和结果。
9 名年龄在 27 岁至 64 岁的女性患者在 2021 年 1 月至 2023 年 10 月期间接受了 US-CBN。最初的影像学异常包括异常的 MRI 增强、乳腺 X 线照相术钙化和超声肿块。在最初或第二次超声检查后，所有的影像学发现都与活检标本的超声特征相对应，其中大多数为超声肿块（8/9）。US-CBN 由 6 名乳腺放射科医生使用各种设备进行。所有活检标本的结果均与超声异常一致，尽管有 1 例与 MRI 上最初发现的异常不一致。没有发生并发症，且手术过程中的不适得到了很好的治疗。有 2 名患者（22%，2/9）被诊断为恶性肿瘤。
这项初步研究表明，US-CBN 可以由乳腺放射科医生进行，以明确诊断乳腺影像学上可疑的乳晕异常，避免手术并保持乳头完整性。在我们的人群中，22%（2/9）的 US-CBN 显示恶性肿瘤。
