Aims and objectives
With the development of mammography and the gradual popularization of breast cancer screening,
more and more non-palpable breast lesions have been detected.This type of non-palpable breast lesion can be positioned under mammography guidance,
followed by needle biopsy or local excision.The current standard for preoperative localisation technique in China is wire-guided localisation(WL) [1].Although WL is simple and effective,
it has the following disadvantages: (1) The wire is exposed outside the body and the patient's comfort is low.(2) Wire can be displaced due to patient activity,
affecting...
Methods and materials
一般数据来自2016年7月至2017年12月收集的72名女性不可触及的乳腺病变患者进行了乳房保留手术,年龄21-65岁,平均(42.3±5.2)岁。患者随机分为RSL组和WL组,并使用不同的方法进行本地化。选择RSL为压迫后乳房厚度<3 cm,胸大肌或皮肤<2 cm(8例)的病变。WL组38例,乳腺成像报告和数据系统(BI-RADS)分类:3类5例,4A 18例,4B 10例,4C 5例。RSL组34例,BI-RADS分类:3例分别为BI-RADS 3例,18例为4A,8例为4B,5例为4C。
使用西门子Mammomat Inspiration乳房X线照相术和3D穿刺系统。用于WL的Bard DuaLoc导丝针(20g 10.
7 cm)带有锚双钩倒刺。放射性种子是I 125,活性为0.3mCi。WL组的定位在切除的同一天进行,RSL组的定位在手术前5天进行。
评估两组患者的精确定位率,无肿瘤边缘率和再切除率,以及定位相关并发症。定位准确标准:钢丝锚钩段或放射性种子的切边小于2厘米; 从病变的近端边缘:附着于乳房病变切除的正常周围组织的范围≥2mm [7] ; 切除标准:快速病理检查首次为阳性,或术中为阴性,但术后病理结果为阳性[8]。此外,观察并记录了位置相关并发症的发生。采用χ2检验比较两组患者的准确率,无肿瘤边缘率和再切除率(P <0.05)。 。
Results
两组患者均在手术前准确定位。乳房X线照相术显示所有病灶均精确定位并完全切除(图1,2)。RSL组第一次切除边缘的阴性率为91.17%(31/34),病灶的再切除率为5.88%(2/34)。在WL组,无肿瘤边缘率为65.79%(25/38),再切除率为28.94%(13/38)。两组间差异有统计学意义(χ2= 6.69,6.45,P <0.01)。在WL组。1例发现迷走神经反应,2例发生移位,RSL组未见明显并发症。
Conclusion
Both of RSL and WL can be used for accurate location and guided-resection of non-palpable breast lesions.
Compared with WL,
the positioning of RSL is not affected by the operation time.
RSL also has the higher tumour-free margin rate and lower re-excision rate.
Personal information
Yun Li,
MD
Department of Radiology,Shandong Cancer Hospital Affiliated to Shandong University
NO440.
Jiyan Road Huaiyin District ,JinanCity,Shandong Province,
China
Phone: +86 53115868
e-mail:
[email protected]
References
[1]Jakub JW,
Gray RJ,
Degnim AC,
et al.
Current status of radioactive seed for localisationof non palpable breast lesions.
Am J Surg,2009,199(4):522-528.
[2]Theunissen CI,
Rust EA,
Edens MA,
et al.
Radioactive seed localisationis the preferred technique in non-palpable breast cancer compared with wire-guided localisationand radioguided non-palpablelesion localisation.
Nucl Med Commun,2017,38(5):396.
[3]Diego EJ,
Soran A,
Mcguire KP,
et al.
Localizing high-risk lesions for excisional breast biopsy: a comparison between radioactive seed localisationand wire localisation.
Ann Surg Oncol,2014,21(10):3268-3272.
[4]Chiu JC,
Ajmal S,
Zhu X,
et al.
Radioactive...