<trans-title xml:lang="en"/>_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

李聪 ¹ , 吕青 ² ,  彭玉兰 ¹

1. ;
2. ;

Corresponding author：

彭玉兰, Email: yulanpeng@163.com

Keywords：

超声引导; 导丝置入定位; 乳腺触诊阴性肿块; 微创切除

DOI：

10.7507/1007-9424.201605114

Video：

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目的探讨超声引导导丝置入定位技术在乳腺触诊阴性肿块微创切除术的应用价值。方法回顾性分析乳腺触诊阴性肿块微创手术切除前进行了超声引导乳腺导丝置入定位技术的377例患者403个肿块的影像和病历资料，统计分析肿块大小、肿块位置、肿块良恶性、病理类型、恶性肿块病理TNM分期、定位成功率、肿块完全切除率等。结果 403个肿块全部被完整切除，且术中证实定位全部成功，定位成功率为100%；肿块平均直径为（10.1±5.1）mm，其中恶性肿块平均直径为（12.5±6.0）mm，良性肿块平均直径为（9.9±5.0）mm，两者间差异有统计学意义（P=0.008）。194个（48.14%）肿块位于外上象限，82个（20.35%）肿块位于内上象限，75个（18.61%）肿块位于外下象限，38个（9.43%）肿块位于内下象限，13个（3.22%）肿块位于中央区；1 个（0.25%）肿块位于胸壁深面肌间，病理学检查证实为淋巴结。病理类型：恶性肿块31个（7.69%）；良性肿块372个（92.31%），其中高危肿块60个（16.13%），淋巴结 1 个，病理结果为反应性增生淋巴结。结论超声引导下导丝置入定位技术可以辅助外科医师精准微创切除临床触诊困难的乳腺小肿块。

Citation： 李聪, 吕青, 彭玉兰. . CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(1): 92-95. doi: 10.7507/1007-9424.201605114 Copy

1.	Ahmed M, van Hemelrijck M, Douek M. Systematic review of radio-guided versus wire-guided localization in the treatment of non-palpable breast cancers. Breast Cancer Res Treat, 2013, 140(2): 241-252.
2.	Fillion MM, Black EA, Hudson KB,et al. The effect of multiple wire localization in breast conservation. Am Surg, 2012, 78(5): 519-522.
3.	Lakhani SR, Ellis IO, Schnitt SJ,et al. WHO Classification of Tumours of the Breast. Fourth Edition. En: WHO Classification of Tumours. International Agency for Research on Cancer, 2012: 1-240.
4.	Balch CM, Gershenwald JE, Soong SJ,et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol, 2009, 27(36): 6199-6206.
5.	Haffty BG, Lee C, Philpotts L,et al. Prognostic significance of mammographic detection in a cohort of conservatively treated breast cancer patients. Cancer J Sci Am, 1998, 4(1): 35-40.
6.	Silverstein MJ, Gamagami P, Rosser RJ,et al. Hooked-wire-directed breast biopsy and over penetrated mammography. Cancer, 1987, 59(4): 715-722.
7.	贾丽琼, 潘炯, 李小强. 超声不同定位方法在乳腺微小肿块术前的应用. 肿瘤影像学, 2013, 22(3): 260-262.
8.	Parvez E, Cornacchi SD, Hodgson N,et al. A cosmesis outcome substudy in a prospective, randomized trial comparing radio-guided seed localization with standard wire localization for non-palpable, invasive, and in situ breast carcinomas. Am J Surg, 2014, 208(5): 711-718.
9.	Sajid MS, Parampalli U, Haider Z,et al. Comparison of radioguided occult lesion localization (ROLL) and wire localization for non-palpable breast cancers: a meta-analysis. J Surg Oncol, 2012, 105(8): 852-858.
10.	Postma EL, Koffijberg H, Verkooijen HM,et al. Cost-effectiveness of radioguided occult lesion localization (ROLL) versus wire-guided localization (WGL) in breast conserving surgery for nonpalpable breast cancer: results from a randomized controlled multicenter trial. Ann Surg Oncol, 2013, 20(7): 2219-2226.
11.	Köhler J, Krause B, Grunwald S,et al. Ultrasound and mammography guided wire marking of non-palpable breast lesions: analysis of 741 cases. Ultraschall Med, 2007, 28(3): 283-290.
12.	梁晓宁, 郭瑞君, 巩丽焕, 等. 超声引导乳腺定位导丝置入在触诊阴性乳腺微钙化肿块中的应用. 中国医学影像技术, 2011, 27(5): 979-981.
13.	Choi SY, Moon YH, Kim YJ,et al. Pathological correlation of re-excised breast lesions after the use of the ultrasound-guided vacuum-assisted biopsy device (Mammotome^®). J Breast Cancer, 2007, 10(4): 273-277.
14.	Park H, Sukim L. The current role of vacuum assisted breast biopsy system in breast disease. J Breast Cancer, 2011, 14(1): 1-7.
15.	Ye L, Wang LP, Deng YB. Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 11-gauge vacuum-assisted biopsy. Chinese-German J Clin Oncol, 2013, 12(5): 228-231.
16.	姚峰, 万颖文, 李娟娟, 等. 超声引导下导丝定位在切除不可触及乳腺病变中的应用. 武汉大学学报(医学版), 2012, 33(6): 846-849.
17.	Postma EL, Verkooijen HM, van Esser S,et al. Efficacy of radioguided occult lesion localization (ROLL) versus wire-guided localization (WGL) in breast conserving surgery for non-palpable breast cancer: a randomized controlled multi-center trial. Breast Cancer Res Treat, 2012, 136(2): 469-478.

1. Ahmed M, van Hemelrijck M, Douek M. Systematic review of radio-guided versus wire-guided localization in the treatment of non-palpable breast cancers. Breast Cancer Res Treat, 2013, 140(2): 241-252.
2. Fillion MM, Black EA, Hudson KB,et al. The effect of multiple wire localization in breast conservation. Am Surg, 2012, 78(5): 519-522.
3. Lakhani SR, Ellis IO, Schnitt SJ,et al. WHO Classification of Tumours of the Breast. Fourth Edition. En: WHO Classification of Tumours. International Agency for Research on Cancer, 2012: 1-240.
4. Balch CM, Gershenwald JE, Soong SJ,et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol, 2009, 27(36): 6199-6206.
5. Haffty BG, Lee C, Philpotts L,et al. Prognostic significance of mammographic detection in a cohort of conservatively treated breast cancer patients. Cancer J Sci Am, 1998, 4(1): 35-40.
6. Silverstein MJ, Gamagami P, Rosser RJ,et al. Hooked-wire-directed breast biopsy and over penetrated mammography. Cancer, 1987, 59(4): 715-722.
7. 贾丽琼, 潘炯, 李小强. 超声不同定位方法在乳腺微小肿块术前的应用. 肿瘤影像学, 2013, 22(3): 260-262.
8. Parvez E, Cornacchi SD, Hodgson N,et al. A cosmesis outcome substudy in a prospective, randomized trial comparing radio-guided seed localization with standard wire localization for non-palpable, invasive, and in situ breast carcinomas. Am J Surg, 2014, 208(5): 711-718.
9. Sajid MS, Parampalli U, Haider Z,et al. Comparison of radioguided occult lesion localization (ROLL) and wire localization for non-palpable breast cancers: a meta-analysis. J Surg Oncol, 2012, 105(8): 852-858.
10. Postma EL, Koffijberg H, Verkooijen HM,et al. Cost-effectiveness of radioguided occult lesion localization (ROLL) versus wire-guided localization (WGL) in breast conserving surgery for nonpalpable breast cancer: results from a randomized controlled multicenter trial. Ann Surg Oncol, 2013, 20(7): 2219-2226.
11. Köhler J, Krause B, Grunwald S,et al. Ultrasound and mammography guided wire marking of non-palpable breast lesions: analysis of 741 cases. Ultraschall Med, 2007, 28(3): 283-290.
12. 梁晓宁, 郭瑞君, 巩丽焕, 等. 超声引导乳腺定位导丝置入在触诊阴性乳腺微钙化肿块中的应用. 中国医学影像技术, 2011, 27(5): 979-981.
13. Choi SY, Moon YH, Kim YJ,et al. Pathological correlation of re-excised breast lesions after the use of the ultrasound-guided vacuum-assisted biopsy device (Mammotome^®). J Breast Cancer, 2007, 10(4): 273-277.
14. Park H, Sukim L. The current role of vacuum assisted breast biopsy system in breast disease. J Breast Cancer, 2011, 14(1): 1-7.
15. Ye L, Wang LP, Deng YB. Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 11-gauge vacuum-assisted biopsy. Chinese-German J Clin Oncol, 2013, 12(5): 228-231.
16. 姚峰, 万颖文, 李娟娟, 等. 超声引导下导丝定位在切除不可触及乳腺病变中的应用. 武汉大学学报(医学版), 2012, 33(6): 846-849.
17. Postma EL, Verkooijen HM, van Esser S,et al. Efficacy of radioguided occult lesion localization (ROLL) versus wire-guided localization (WGL) in breast conserving surgery for non-palpable breast cancer: a randomized controlled multi-center trial. Breast Cancer Res Treat, 2012, 136(2): 469-478.

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