Jones M K, Vetto J T, Pommier R F, Thurmond A S, Woltering E A
Department of Radiology, Oregon Health Sciences University, Portland 97201.
J Am Coll Surg. 1994 Jun;178(6):548-52.
We have created a modified technique of localization biopsy of the breast that more easily identifies the position of the wire tip after placement and before biopsy. After wire placement, metallic skin markers are placed on the nipple and wire entry site. The patient is then positioned on a roentgenography table in the same position to be used during biopsy. A supine roentgenogram of the breast is obtained. At the time of the biopsy, this roentgenogram is aligned with the corresponding markers on the skin of the patient and the position of the wire tip is noted. A curvilinear incision along Langer's lines can then be made at that site. This procedure was used in 53 consecutive biopsies of nonpalpable mammary lesions. In all instances, the biopsy incisions were independent of the wire insertion sites and in each instance, the lesion was excised in a single specimen. Compared with other techniques, our method is simple, inexpensive, requires no special equipment and results in only a minimal increase in radiation dose to the breast (50 millirad). The decrease in the amount of tissue dissection without decreasing accuracy afforded by our technique can improve compliance with the American Cancer Society's recommended surgical guidelines for breast preservation therapy.
我们创建了一种改良的乳腺定位活检技术，该技术能在放置导丝后、活检前更轻松地确定导丝尖端的位置。放置导丝后，在乳头和导丝进入部位放置金属皮肤标记物。然后让患者躺在X线检查台上，保持与活检时相同的体位。获取乳房的仰卧位X线片。在活检时，将这张X线片与患者皮肤上相应的标记物对齐，并记录导丝尖端的位置。然后在该部位沿朗格线做一条曲线切口。该方法用于连续53例不可触及乳腺病变的活检。在所有病例中，活检切口均与导丝插入部位无关，且在每例中，病变均在单个标本中被切除。与其他技术相比，我们的方法简单、成本低，无需特殊设备，且只会使乳房的辐射剂量略微增加（50毫拉德）。我们的技术在不降低准确性的情况下减少了组织切除量，这可以提高对美国癌症协会推荐的保乳治疗手术指南的依从性。
