della Rovere G Q, Benson J R, Morgan M, Warren R, Patel A
The Royal Marsden Hospital, Sutton, UK.
Eur J Surg Oncol. 1996 Oct;22(5):478-82. doi: 10.1016/s0748-7983(96)92853-x.
The conventional approach to localization of impalpable breast lesions, i.e. employing a hooked wire with either stereotaxis or a perforated plate, has potential disadvantages for the operating surgeon. Often the entry point of the wire lies some distance from the site of projection of the lesion on the skin. The guide-wire should pierce the skin at, or close to, the site of any proposed surgical incision and proceed along the shortest and most direct course towards the lesion. Ideally, the wire should lie within a radial distance of between 1 and 2 cm from its target. A method is described which achieves these objectives and involves both radiological and clinical measurements. A total of 665 guide-wire localized biopsies have been carried out at the above institutions between 1 November 1987 and 31 March 1995 and between 1 January 1994 and 31 March 1996. In only 4% of cases was re-positioning of the wire required. Excision of the radiological lesion was obtained with a single biopsy in 99% of cases. A second or third biopsy was indicated in 0.7% and 0.3% of cases, respectively. Migration of the wire occurred in two patients and no cases of wire transection or pneumothorax were reported. This method of localization facilitates subsequent excision and permits the most appropriate incision consistent with optimal cosmesis.
对于无法触及的乳腺病变进行定位的传统方法，即使用带有立体定位或穿孔板的钩丝，对外科手术医生存在潜在的不利之处。通常，钢丝的进针点与病变在皮肤上的投影位置有一定距离。导丝应在任何拟行手术切口的部位或其附近穿透皮肤，并沿着最短、最直接的路径朝向病变。理想情况下，导丝应位于距其目标1至2厘米的径向距离内。本文描述了一种实现这些目标的方法，该方法涉及放射学和临床测量。在1987年11月1日至1995年3月31日以及1994年1月1日至1996年3月31日期间，上述机构共进行了665例导丝定位活检。仅4%的病例需要重新定位导丝。99%的病例通过单次活检切除了放射学上的病变。分别有0.7%和0.3%的病例需要进行第二次或第三次活检。有两名患者出现导丝移位，未报告导丝切断或气胸病例。这种定位方法便于后续切除，并允许做出与最佳美容效果相一致的最合适切口。
