Clinical Application Value of Steel Wire Located Biopsy of Nonpalpable Breast Lesion by X-Ray_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 史立暉 , 李智 , 張騰 , 張曉君 , 顧岳山

北京市通州區婦幼保健院（北京 101101）;

Corresponding?author：

史立暉, Email: sup118@aliyun.com

Keywords：

乳腺癌; 觸診陰性; 定位

DOI：

10.7507/1007-9424.20140312

Video：

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目的探討鉬靶X線導絲定位切除觸診陰性乳腺病灶手術的臨床應用價值。方法對291例299個觸診陰性乳腺病灶在鉬靶X線指引下經導絲定位并切除活檢，確定病理類型。結果 299個觸診陰性乳腺病灶中乳腺癌病灶42個（14.05%），癌前病變40個（13.38%），良性病變257個（85.95%），其中乳腺癌灶多表現為簇狀或彌漫細點狀鈣化，乳腺癌病灶中原位癌22個（52.38%，22/42），浸潤癌Ⅰ期13個（30.95%，13/42），Ⅱ期4個（9.52%，4/42），Ⅲ期3個（7.15%，3/42）。40例乳腺癌患者（2例為雙側癌）均長期隨訪，最長隨訪時間為10年，復發轉移2例。應用鉬靶X線診斷乳腺癌的靈敏度為92.86%（39/42）；特異度為95.33%（245/257），診斷比值比（DOR）為265.42。結論鉬靶X線導絲定位病灶切除技術可提高觸診陰性乳腺病灶的早期診斷率，指導手術切除病灶，其組織損傷小，可靠性高，促進了乳腺癌二級預防，適合二級醫院廣泛應用。

Citation： 史立暉, 李智, 張騰, 張曉君, 顧岳山. Clinical Application Value of Steel Wire Located Biopsy of Nonpalpable Breast Lesion by X-Ray. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1299-1301. doi: 10.7507/1007-9424.20140312 Copy

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2. 申龍河, 金日.乳腺鉬靶載線攝影及乳腺微小鈣化灶定位活檢在觸診陰性乳腺疾病診治中的臨床意義[J].中國醫藥指南, 2008, 3(6):12-14.
3. Esserman LE, Cura MA, DaCosta D. Recognizing pitfalls in earlyand late migration of clip markers after imaging-guided directionalvacuum-assisted biopsy[J]. Radiographics, 2004, 24(1):147-156.
4. 魏冉, 張蓓, 胡文娟, 等. X線導引下乳腺鈣化導絲定位活檢的應用價值[J].中國癌癥雜志, 2011, 21(6):473-477.
5. Coleman MP, Quaresma M, Berrino F, et al. Cancer survival in five continents:a worldwide population-based study (CONCORD)[J]. Lancet Oncol, 2008, 9(8):730-756.
6. Zujewski JA, Harlan LC, Morrell DM, et al. Ductal carcinoma in situ:trends in treatment over time in the US[J]. Breast Cancer Res Treat, 2011, 127(1):251-257.
7. 朱思吉, 吳佳毅, 陳偉國.乳腺小葉原位癌外科治療進展[J].中國實用外科雜志, 2013, 33(3):230-233.
8. 王頎, 連臻強.乳腺癌早期診斷的臨床思路[J].中華乳腺病雜志:電子版, 2010, 4(4):357-360.
9. 李春艷, 侯國芳, 張晟, 等.乳腺導管內癌治療方式研究進展[J].中國老年學雜志, 2013, 33(4):963-966.
10. 王仲照, 張保寧.觸診陰性乳腺病灶活檢在乳腺癌早診早治中的價值[J].中國普外基礎與臨床雜志, 2005, 12(3):223-225.
11. 許艷春, 姚曉虹, 祝明潔.乳腺非典型性導管增生的研究進展[J].上海交通大學學報:醫學版, 2014, 33(4):516-520.
12. Otterbach F, Bankfalvi A, Bergner S, et al. Cytokeratin 5/6 immunohistochemistry assists the differential diagnosis of atypical proliferations of the breast[J]. Histopathology, 2000, 37(3):232-240.
13. Fitzgibbons PL, Henson DE, Hutter RV. Benign breast changes and the risk for subsequent breast cancer:an update of the 1985 consensus statement. Cancer Committee of the College of American Pathologists[J]. Arch Pathol Lab Med, 1998, 122(12):1053-1055.
14. 趙紅, 鄭穗生, 金晶, 等.鉬靶X線影像對乳腺疾病的診斷價值[J].中國醫學影像學雜志, 2012, 20(7):511-514.
15. 趙玉年, 徐向紅, 崔懷萍, 等.乳腺內微鈣化在乳腺癌診斷中的價值[J].腫瘤基礎與臨床, 2010, 23(4):342-344.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Application Value of Steel Wire Located Biopsy of Nonpalpable Breast Lesion by X-Ray

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