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中华介入放射学电子杂志 ›› 2021, Vol. 09 ›› Issue (03) : 300 -306. doi: 10.3877/cma.j.issn.2095-5782.2021.03.011

非血管介入

X线立体定位真空辅助活检术对可疑乳腺钙化灶的应用价值
石剑1, 魏建南1, 曾圣光1, 何健龙2, 谢娜2, 郑爱秋1,(), 杨勇1   
  1. 1. 518048 广东深圳,香港大学深圳医院乳腺外科
    2. 518048 广东深圳,香港大学深圳医院影像中心
  • 收稿日期:2021-04-20 出版日期:2021-08-25
  • 通信作者: 郑爱秋
  • 基金资助:
    广东省医学科学技术研究基金(A2018194)

Application value of X-ray stereotactic vacuum-assisted biopsy for suspected breast calcification

Jian Shi1, Jiannan Wei1, Shengguang Zeng1, Jianlong He2, Na Xie2, Aiqiu Zheng1,(), Yong Yang1   

  1. 1. Devision of Breast Surgery, the University of Hong Kong-Shenzhen Hospital, Guangdong Shenzhen 518048, China
    2. Department of Medical Imaging, the University of Hong Kong-Shenzhen Hospital, Guangdong Shenzhen 518048, China
  • Received:2021-04-20 Published:2021-08-25
  • Corresponding author: Aiqiu Zheng
引用本文:

石剑, 魏建南, 曾圣光, 何健龙, 谢娜, 郑爱秋, 杨勇. X线立体定位真空辅助活检术对可疑乳腺钙化灶的应用价值[J/OL]. 中华介入放射学电子杂志, 2021, 09(03): 300-306.

Jian Shi, Jiannan Wei, Shengguang Zeng, Jianlong He, Na Xie, Aiqiu Zheng, Yong Yang. Application value of X-ray stereotactic vacuum-assisted biopsy for suspected breast calcification[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2021, 09(03): 300-306.

目的

探讨X线立体定位真空辅助活检术(SVAB)在可疑乳腺钙化灶诊治中的应用价值。

方法

以2015年12月至2019年12月在香港大学深圳医院因可疑乳腺钙化灶行X线立体定位活检的女性患者为研究对象,评估该活检方式的有效性、安全性及低估率情况。

结果

518位患者(双侧病变患者40位),共计558侧病变均顺利完成活检。手术病理示恶性病变74例(导管原位癌59例,导管原位癌伴局灶浸润性癌7例,浸润性导管癌7例,浸润性微乳头状癌1例),非典型导管上皮增生45例,良性病变439例。病理低估率导管原位癌为6.8%(4/59),非典型导管上皮增生为2.2%(1/45)。

结论

SVAB对可疑乳腺钙化灶定位、活检准确,安全易行,在临床表现不明确的早期乳腺癌的术前诊断中起着重要的作用。

Objective

To explore the application value of stereotactic vacuum-assisted biopsy (SVAB) in the diagnosis and treatment of suspicious breast calcification.

Methods

From December 2015 to December 2019, female patients who underwent X-ray stereotactic biopsy due to suspicious breast calcification in Hong Kong-Shenzhen Hospital,were selected as subjects to evaluate the efficacy, safety and underestimation rate of this biopsy method.

Results

A total of 558 biopsies were completed successfully in 518 patients (40 bilateral cases). Surgical pathology showed malignant lesions in 74 cases (59 cases of ductal carcinoma in situ, 7 cases of ductal carcinoma in situ with focal invasive carcinoma, 7 cases of invasive ductal carcinoma, and 1 case of invasive micropapillary carcinoma), atypical ductal hyperplasia in 45 cases, and benign lesions in 439 cases. Pathologically underrated rates were 6.8% (4/59) for ductal carcinoma in situ and 2.2% (1/45) for atypical ductal hyperplasia.

Conclusions

SVAB is safe and accurate for the location and biopsy of suspicious breast calcification, and plays an important role in the preoperative diagnosis of early breast cancer with unclear clinical manifestations.

图1 可疑钙化灶立体定位
图2 ATEC击发后与钙化空间位置情况
图3 SVAB360°旋切后残余钙化情况
图4 活检标本情况
图5 钙化完全切取术后
表1 钙化临床特征与病理相关性[SVAB(n=558)]
[1]
Gajdos C, Tartter PI, Bleiweiss IJ, et al. Mammographic appearance of nonpalpable breast cancer reflects pathologic characteristics[J]. Ann Surg, 2002, 235(2): 246-251.
[2]
Bent CK, Bassett LW, D'Orsi CJ, et al. The positive predictive value of BI-RADS mi-crocalcification descriptors and final as?sessment categories[J]. Am J Roentgenol, 2010, 194(5): 1378-1383.
[3]
Sickles EA, D'Orsi CJ, Bassett LW, et al. ACR BI-RADS Atlas (breast imaging reporting and data system) [M]. Reston:American College of Radiology, 2013: 61-78, 135-138.
[4]
Jackman RJ, Burbank F, Parker SH, et al. Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates[J]. Radiology, 2001, 218(2): 497-502.
[5]
邹如海,韩峰,曹云, 等. 超声引导乳腺肿物穿刺活检导致病理组织学诊断低估的原因分析[J]. 中华医学超声杂志(电子版), 2010, 7(1): 60-65.
[6]
石剑,魏建南,曾圣光,等. ATEC活检系统在乳腺钙化灶立体定位活检中的应用[J]. 中国微创外科杂志, 2020, 20(10): 865-870.
[7]
Penco S, Rizzo S, Bozzini A C, et al. Stereotactic vacuum-assisted breast biopsy is not a therapeutic procedure even when all mammographically found calcifications are removed: analysis of 4,086 procedures[J]. Ajr Am J Roentgenol, 2010, 195(5): 1255-1260.
[8]
Park H L, Hong J. Vacuum-assisted breast biopsy for breast cancer[J]. Gland Surgery, 2014, 3(2): 120-127.
[9]
Safioleas P M, Koulocheri D, Michalopoulos N, et al. The value of stereotactic vacuum assisted breast biopsy in the investigation of microcalcifications. A six-year experience with 853 patients[J]. J BUON, 2017, 22(2): 340-346.
[10]
Shozo O, Shigemitsu T, Kenjiro A, et al. Breast biopsy for mammographically detected non-palpable lesions using a vacuum-assisted biopsy device (mammotome) and an upright-type stereotactic mammography unit[J]. Jpn J Cli Oncol, 2001, 31(11): 527-531.
[11]
Renshaw AA, Gould EW. Long term clinical follow-up of atypical ductal hyperplasia and lobular carcinoma in situ in breast core needle biopsies[J]. Pathology, 2016, 48(1): 25-29.
[12]
Latronico A, Nicosia L, Faggian A, et al. Atypical ductal hyperplasia: our experience in the management and long term clinical follow-up in 71 patients[J]. Breast, 2018, 37(2): 1-5.
[13]
Youn I, Kim M J, Moon H J, et al. Absence of residual microcalcifications in atypical ductal hyperplasia diagnosed via stereotactic vacuum-assisted breast biopsy: is surgical excision obviated?[J]. J Breast Cancer, 2014, 17(3): 265-269.
[14]
Esen G, T utar B, Uras C, et al. Vacuum-assisted stereotactic breast biopsy in the diagnosis and management of suspicious microcalcifications[J]. Diagn Interv Radiol, 2016, 22(4): 326-333.
[15]
Rageth CJ, Rubenov R, Bronz C, et al. Atypical ductal hyperplasia and the risk of underestimation: tissue sampling method, multifocality, and associated calcification significantly influence the diagnostic upgrade rate based on subsequent surgical specimens[J]. Breast Cancer, 2019, 26(4): 452-458.
[16]
Chang SLQ, Huang ML, Leung JWT, et al. Malignancy rates of stereotactic biopsies of two or more distinct sites of suspicious calcifications in women without known breast cancer[J]. Clinical Imaging, 2019, 58: 156-160.
[17]
Raj SD, Sedgwick EL, Severs FJ, et al. Stereotactic biopsy of segmental breast calcifications: is sampling of anterior and posterior components necessary?[J]. Acad Radiol, 2016, 23(6): 682-686.
[18]
Li S, Qu F, Yang Y, et al. Value of stereotactic 11-gauge vacuum-assisted breast biopsy in non-palpable suspicious calcifications: an eight-year single institution experience with 587 patients[J]. Gland Surgery, 2020, 9(5): 1258-1266.
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