Morrow M, Schmidt R, Cregger B, Hassett C, Cox S
Department of Surgery, University of Chicago, Ill.
Arch Surg. 1994 Oct;129(10):1091-6. doi: 10.1001/archsurg.1994.01420340105021.
To prospectively evaluate a program of additional mammographic views, interval follow-up, and stereotactic biopsy in the management of abnormalities detected on mammograms.
From June 1988 to September 1991, 267 consecutive women who were referred for surgical consultation because of an abnormal mammographic finding were evaluated. Mammographic abnormalities were assessed as benign or as requiring interval follow-up, stereotactic biopsy, open surgical biopsy, or additional views. Women having additional mammographic views were reassigned to the preceding groups. The mean follow-up for women who did not have a biopsy was 37 months.
Only 129 (48%) of the women who were sent for surgical consultation underwent open biopsy, and 46 (36%) of the biopsy specimens revealed carcinoma. Forty-one (89%) of the cancers were ductal carcinoma in situ or stage I lesions. Of the 117 women who were assigned to follow-up, six (5%) subsequently required biopsy and two cancers were identified.
Rigorous mammographic evaluation and the use of stereotactic biopsy for selected lesions can prevent breast biopsy for low-suspicion mammographic abnormalities while still allowing the detection of early-stage breast cancer.
前瞻性评估一项针对乳腺钼靶检查发现的异常情况进行额外钼靶投照、间期随访及立体定向活检的方案。
1988年6月至1991年9月，对因乳腺钼靶检查结果异常而转诊进行外科会诊的267例连续女性患者进行了评估。乳腺钼靶异常情况被评估为良性或需要进行间期随访、立体定向活检、开放手术活检或额外投照。接受额外钼靶投照的女性被重新归类到之前的组中。未进行活检的女性的平均随访时间为37个月。
在被送去进行外科会诊的女性中，只有129例（48%）接受了开放活检，其中46例（36%）活检标本显示为癌。41例（89%）癌症为原位导管癌或I期病变。在被安排进行随访的117例女性中，有6例（5%）随后需要进行活检，其中发现了2例癌症。
严格的乳腺钼靶评估以及对选定病变使用立体定向活检，可以避免对乳腺钼靶可疑度低的异常情况进行乳腺活检，同时仍能检测出早期乳腺癌。
