Fajardo L L, DeAngelis G A
Department of Radiology, University of Virginia, Charlottesville, USA.
Surg Oncol Clin N Am. 1997 Apr;6(2):285-99.
Core needle biopsy using either stereotactic or ultrasonographic guidance is a reasonable and accurate alternative to surgical biopsy for diagnosis of most nonpalpable breast lesions. An important component of a stereotactic core breast biopsy procedure is the mammographic and pathologic correlation of findings to plan optimal patient management. The level of suspicion of a mammographic lesion, the accuracy of stereotactic targeting, and the confirmation of microcalcifications in specimen radiographs for calcified lesions must be considered carefully and correlated with the histopathologic findings. Meticulous operator technique is essential to provide representative samples of the mammographic abnormality. Properly performed, imaging-guided percutaneous core breast biopsy has reduced the morbidity of surgical breast biopsy and the overall cost of breast cancer diagnosis. Recent work has demonstrated that stereotactic core breast biopsy can reduce the cost of diagnosing mammographically detected breast lesions by more than 50%. At a time when health-care policy and reimbursement decisions are influenced by cost considerations, increased use of stereotactic core breast biopsy is anticipated. Meticulous attention to technique allows maximal realization of the benefits of this procedure.
对于大多数不可触及的乳腺病变，采用立体定位或超声引导的粗针活检是一种合理且准确的手术活检替代方法，用于诊断。立体定位乳腺粗针活检程序的一个重要组成部分是将乳腺X线摄影和病理检查结果进行关联，以规划最佳的患者管理方案。必须仔细考虑乳腺X线摄影病变的可疑程度、立体定位靶向的准确性以及钙化病变标本X线片中微钙化的确认情况，并将其与组织病理学结果相关联。细致的操作技术对于获取乳腺X线摄影异常的代表性样本至关重要。正确实施的影像引导经皮乳腺粗针活检降低了手术乳腺活检的发病率以及乳腺癌诊断的总体成本。最近的研究表明，立体定位乳腺粗针活检可将乳腺X线摄影检测到的乳腺病变的诊断成本降低超过50%。在医疗保健政策和报销决策受成本因素影响的当下，预计会增加立体定位乳腺粗针活检的使用。对技术的细致关注可最大程度地实现该程序的益处。
