Ben Aharon U, Lifscitz O, Strano S D, Mavor E, Barzilai N
Dept. of Surgery, Kaplan Medical Center, Rohovot.
Harefuah. 1995 Feb 15;128(4):205-7, 264.
Mammography remains the recommended method of detecting nonpalpable breast lesions. With increasing use of mammography as a screening and diagnostic modality for breast disease, more needle-localized biopsies are being performed. Preoperative localization of lesions detected by mammography enables the surgeon to resect affected breast tissue more accurately. The surgical biopsy should be a 1-step procedure with wide local excision. If it reveals malignancy, further surgical treatment should be planned, based on the clinical and pathological data. In our prospective study biopsies with localization were performed in 68 women; in 21 (30.9%) malignancy was found: solitary duct cell carcinoma in situ in 10 (multifocal in 4), duct cell carcinoma in situ with microinvasion in 3, and invasive carcinoma in 8. Lobular cancer was not found. Treatment consisted of mastectomy in 10 and breast conservation surgery in 11. Further studies are needed to clarify issues involved in surgical management of carcinoma-in-situ.
乳腺钼靶摄影仍然是检测不可触及乳腺病变的推荐方法。随着乳腺钼靶摄影作为乳腺疾病筛查和诊断手段的使用增加,更多的针定位活检正在进行。通过乳腺钼靶摄影检测到的病变的术前定位使外科医生能够更准确地切除受影响的乳腺组织。手术活检应是一步进行广泛局部切除的操作。如果显示为恶性肿瘤,则应根据临床和病理数据规划进一步的手术治疗。在我们的前瞻性研究中,对68名女性进行了定位活检;其中21例(30.9%)发现为恶性肿瘤:10例为孤立性导管原位癌(4例为多灶性),3例为导管原位癌伴微浸润,8例为浸润性癌。未发现小叶癌。10例接受了乳房切除术,11例接受了保乳手术。需要进一步研究以阐明原位癌手术管理中涉及的问题。