Dixon J M, Ravi Sekar O, Walsh J, Paterson D, Anderson T J
Edinburgh Breast Unit, Western General Hospital, UK.
Br J Surg. 1993 Aug;80(8):1001-2. doi: 10.1002/bjs.1800800822.
Eighty patients with impalpable breast lesions detected by mammographic screening underwent hookwire-guided wide local excision. Excision specimens were orientated with Ligaclips and submitted to radiography; if, on the specimen radiograph, the mammographic lesion crossed any visible margin, further tissue was excised. Clear histological margins were obtained on the initial excision in 52 (68 per cent) of 77 carcinomas. After inspection of the orientated specimen radiograph, further tissue was excised from 22 patients; this significantly increased the rate of complete excision to 86 per cent (P < 0.01). Significantly more patients with invasive cancer had a complete excision than those with ductal carcinoma in situ (52 of 57 versus 14 of 20, P < 0.02).
80例通过乳腺钼靶筛查发现的触诊不清的乳腺病变患者接受了钩丝引导下的局部广泛切除。切除标本用结扎夹定位并进行放射照相；如果在标本放射照片上，乳腺钼靶病变越过任何可见边缘，则切除更多组织。77例癌中的52例（68%）在初次切除时获得了清晰的组织学切缘。在检查定位后的标本放射照片后，22例患者切除了更多组织；这显著提高了完整切除率至86%（P<0.01）。浸润性癌患者的完整切除率显著高于导管原位癌患者（57例中的52例对20例中的14例，P<0.02）。
