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[采用带套管的立体定向切除活检术诊断乳腺不可触及病变。直径20毫米的先进乳腺活检器械(ABBI)]

[Diagnosis of non-palpable lesions of the breast with stereotactic excisional biopsy with cannula. Advanced Breast Biopsy Instrumentation (ABBI) with fine diameter of 20 mm].

作者信息

Damascelli B, Frigerio L F, Patelli G, Lanocita R, Viganotti G, Magnoni S, Uslenghi E, Tomasich G

机构信息

Divisione Radiologica D, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano.

出版信息

Radiol Med. 1998 May;95(5):437-44.

PMID:9687917
Abstract

PURPOSE

To evaluate the advisability of use by interventional radiologists of the ABBI system for stereotactic biopsy in the diagnosis of mammographically detected nonpalpable breast lesions considered suspicious for cancer.

MATERIAL AND METHODS

Breast biopsy with the ABBI cannula, available in various diameters, was offered to 61 patients who gave their informed consent and was performed in 36. Reasons for exclusion were insufficient thickness of the compressed breast (37.5%), the lesion site (50%) and the failure to detect the lesion with stereotactic mammography (12.5%). The procedure was carried out under local anesthesia in an outpatient setting. Fifteen nodules, 15 groups of microcalcifications and 6 nodules with calcifications were excised. The diameter of the ABBI cannula used was 20 mm in 32 cases and 15 mm in four cases.

RESULTS

A definitive histological diagnosis was obtained in all cases, with the identification of 20 neoplasms (56%) and 16 benign lesions (44%). The lesions margins were involved in 14 cases of malignancy. All the patients with a diagnosis of malignancy underwent surgery. No residual tumor was found in five cases. The mean diameter of the lesions removed was 11-12 mm. The only complications were two late hematomas which were drained by simple percutaneous aspiration. The procedure was well tolerated by all patients except one who experienced a vagal attack due to emotional stress.

CONCLUSIONS

Stereotactic breast biopsy with an ABBI surgical cannula can be carried out autonomously by interventional radiologists, safely and with diagnostic accuracy.

摘要

目的

评估介入放射科医生使用ABBI系统进行立体定向活检以诊断乳腺钼靶检查发现的疑似癌症的不可触及乳腺病变的可行性。

材料与方法

向61名签署知情同意书的患者提供了不同直径的ABBI套管针进行乳腺活检,其中36例进行了活检。排除原因包括乳房压迫厚度不足(37.5%)、病变部位(50%)以及立体定向乳腺摄影未能检测到病变(12.5%)。该操作在门诊局部麻醉下进行。切除了15个结节、15组微钙化灶以及6个伴有钙化的结节。使用的ABBI套管针直径在32例中为20mm,4例中为15mm。

结果

所有病例均获得了明确的组织学诊断,其中20例为肿瘤(56%),16例为良性病变(44%)。14例恶性病变的边缘受累。所有诊断为恶性肿瘤的患者均接受了手术。5例未发现残留肿瘤。切除病变的平均直径为11 - 12mm。仅有的并发症是2例迟发性血肿,通过简单的经皮抽吸引流。除1例因情绪紧张发生迷走神经发作外,所有患者对该操作耐受性良好。

结论

介入放射科医生可自主使用ABBI手术套管针进行立体定向乳腺活检,操作安全且诊断准确。

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