Liberman L, Dershaw D D, Durfee S, Abramson A F, Cohen M A, Hann L E, Rosen P P
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Radiology. 1995 Dec;197(3):735-8. doi: 10.1148/radiology.197.3.7480747.
To evaluate the utility of stereotaxic core biopsy (SCB) in diagnosing recurrent carcinoma after breast-conserving therapy (BCT).
Of 316 patients evaluated with SCB, 17 (5%) had nonpalpable lesions in breasts previously treated with BCT. Surgical correlation was obtained in 14 patients. SCBs were performed with digital stereotaxic equipment, with patients prone.
Carcinoma detected at SCB in 11 (79%) of 14 patients included infiltrating ductal carcinoma (IFDC) in five, ductal carcinoma in situ (DCIS) in five, and infiltrating lobular carcinoma (ILC) in one. Surgical histopathologic findings agreed with core biopsy findings in 10 of these patients. In one patient with two SCB-proved foci of IFDC, one IFDC was identified at mastectomy. In two (14%) patients, SCB revealed atypical ductal hyperplasia; however, DCIS was found at surgical biopsy. In one patient, the SCB finding of fat necrosis was confirmed at surgical biopsy.
These data suggest that SCB may be useful in diagnosing recurrent carcinoma in the conservatively treated breast.
评估立体定向芯针活检（SCB）在诊断保乳治疗（BCT）后复发性癌中的应用价值。
在接受SCB评估的316例患者中，有17例（5%）在先前接受BCT治疗的乳房中存在不可触及的病变。14例患者获得了手术相关性结果。SCB采用数字立体定向设备进行，患者取俯卧位。
14例患者中有11例（79%）在SCB时检测到癌，其中浸润性导管癌（IFDC）5例，原位导管癌（DCIS）5例，浸润性小叶癌（ILC）1例。其中10例患者的手术组织病理学结果与芯针活检结果一致。在1例经SCB证实有两个IFDC病灶的患者中，乳房切除术时发现1个IFDC。2例（14%）患者SCB显示非典型导管增生；然而，手术活检发现为DCIS。1例患者，手术活检证实了SCB发现的脂肪坏死。
这些数据表明，SCB可能有助于诊断保乳治疗后乳房的复发性癌。
