Objective To discuss the surgical indication of mammotome (MMT) operation and its auxiliary diagnosis value on breast cysts.
Methods Seventy-eight patients with breast cysts from May 2010 to November 2011 in this hospital were enrolled. Excision and biopsy were performed according to the following guidelines:Single cyst with inhomogeneous interna echoes and diameter at least 1 cm;Multiple cysts associated with irregular megalgia, localized thickening of breast or ineffective drug treatment after three months;High risk of breast cancer;Hypoechoic nodules and laticifers exaggerated cysts;Ultrasonography showed disorderly echo and abundant blood supply in glandular tissues around the lesions. The result of preoperative ultrasound was compared with that of postoperative pathology diagnosis.
Results In these 78 breast cysts patients with preoperative ultrasound diagnosis, 40 cases were breast multiple cysts, 38 cases were multiple cysts plus untouchable hypoecho nodules;42 cases were high risk lesions, and the other 36 cases were low risk lesions. Postoperative pathology diagnosis revealed 27 cases of cystic hyperplasia, 2 cases of atypical hyperplasia, and 1 case of breast cancer in the ultrasonic high risk lesions, and 19 cases of cystic hyperplasia in the ultrasonic low risk lesions. Ultrasound diagnostic accuracy rate was 60.26%(47/78), sensitivity was 61.22%(30/49), and specificity was 58.62%(17/29). The number of resection lesions was 13.00±8.16, the time of operation was (74.25±22.68) min. The average hospital stay was 1 d after surgery. The local hematoma occurred in 2 cases and no other complications occurred during one month of follow-up.
Conclusions The guidelines of MMT protocoled according to clinical manifestation of breast cyst patients and imaging of high-frequency ultrasound in author’s department are simple and utility. Minimal excision and biopsy via MMT can confirm the histological type and help for early diagnosis of breast cancer and precancerous lesion. It is important and necessary to standardize the surgical indications of MMT in the clinical work.
Citation:
LUO Jing,WU Jian,ZHOU Hong,YAO Xinmin,ZHANG Wenjie,LIU Hong,ZHANG Yan,XU Zhangbo,CHEN Liping,LIU Ying,WANG Jing,WANG Ping. Value of Mammotome for Excision and Biopsy in Breast Cysts. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(5): 532-535. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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张爱玲, 刘碧华, 张月欢, 等. 乳腺囊性肿块的诊治体会(附220例报告)[J]. 中国普外基础与临床杂志, 2005, 12(3):251-252.
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- 1. 阚秀. 乳腺癌临床病理学[M]. 北京:北京医科大学、中国协和医科大学联合出版社, 1993:103-106.
- 2. 刘彤华, 廖松林, 阚秀, 等. 乳腺增生症及乳腺癌组织学分类(推荐方案)[J]. 中华病理学杂志, 1997, 26(6):3-4.
- 3. Tea MK, Grimm C, Heinz-Peer G, et al. The predictive value of suspicious sonographic characteristics in atypical cyst-like breast lesions[J]. Breast, 2011, 20(2):165-169.
- 4. 叶少芳, 钟小英, 冼康明. 空芯针穿刺活检在乳腺局限性增厚病变诊断中的应用[J]. 国际医药卫生导报, 2008, 14(22):41-42.
- 5. 吴祥德, 董守义. 乳腺疾病诊治[M]. 北京:人民卫生出版社, 2004:218-219.
- 6. 付丽, 付笑影, 草间律, 等. 乳腺交界性病变不典型囊性导管的临床病理学特征[J]. 中华病理学杂志, 2004, 33(3):33-36.
- 7. Berg WA, Sechtin AG, Marques H, et al. Cystic breast masses and the ACRIN 6666 experience[J]. Radiol Clin North Am, 2010, 48(5):931-987.
- 8. 皮小兰, 张俭民, 李车英, 等. 乳腺增生症声像图表现与病理对照分析[J]. 实用中西医结合临床, 2009, 9(1):65-66.
- 9. 田家玮, 王素梅, 孙艳, 等. 彩超诊断乳腺增生症及病理分型800例回顾[J]. 中国医学影像技术, 1997, 13(1):63-64.
- 10. 李志艳, 徐龙江, 李德树, 等. 利用超声引导Mammotome对乳腺增生症活检及治疗的临床意义探讨[J]. 西南军医, 2007, 75(4):40-41.
- 11. 王伟平. 乳腺增生症的彩色多普勒分型与病理组织类型的比较研究[J]. 实用医技杂志, 2007, 14(14):1848-1849.
- 12. 宫玉榕, 张宁, 蒋家统, 等. 高频彩色多普勒超声在乳腺增生症诊断中的应用[J]. 福建医药杂志, 2007, 29(4):109-111.
- 13. 孔祥海, 杨迎青, 杨媛, 等. 高频及彩色多普勒超声对乳腺增生症的诊断分析[J]. 安徽医学, 2010, 31(11):1345-1346, 1401.
- 14. 姚晓松, 张颖, 陈菲. BI-RADS分级诊断标准在乳腺疾病超声诊断中的应用[J]. 中国临床研究, 2012, 25(3):283-284.
- 15. Lee HJ, Kim EK, Kim MJ, et al. Observer variability of Breast Imaging Reporting and Data System (BI-RADS) for breast ultrasound[J]. Eur J Radiol, 2008, 65(2):293-298.
- 16. 鲁正贤, 陶劲. 乳腺增生性疾病的超声诊断与病理诊断符合率低下的原因分析[J]. 实用医技杂志, 2008, 15(20):2630-2631.
- 17. 丁雯雯, 张开红, 丁红宇. 乳腺增生症的超声诊断现状及进展[J]. 医学影像学杂志, 2009, 19(9):1190-1192.
- 18. Berg WA, Blume JD, Cormack JB, et al. Lesion detection and characterization in a breast US phantom: results of the ACRIN 6666 investigators[J]. Radiology, 2006, 239(3):693-702.
- 19. 傅西林, 李树玲, 范宇, 等. 乳腺癌前病变与乳腺癌相关的多指标病理学研究[J]. 中国肿瘤临床, 1999, 26(1):6-11.
- 20. Erbas H, Erten O, Irfanoglu ME. Prostatic acid phosphatase in breast cyst fluid[J]. Malays J Pathol, 2007, 29(2):95-99.
- 21. Si?man AR, Sis B, Canda T, et al. Electrolytes and trace elementsin human breast cyst fluid[J]. Biol Trace Elem Res, 2009, 128 (1):18-30.
- 22. Mannello F, Tonti GA, Darbre PD. Concentration of aluminium in breast cyst fluids collected from women affected by gross cystic breast disease[J]. J Appl Toxicol, 2009, 29(1):1-6.
- 23. Hess JC, Sedghinasab M, Moe RE, et al. Growth factor profiles in breast cyst fluid identify women with increased breast cancer risk[J]. Am J Surg, 1994, 167(5):523-530.
- 24. 张爱玲, 刘碧华, 张月欢, 等. 乳腺囊性肿块的诊治体会(附220例报告)[J]. 中国普外基础与临床杂志, 2005, 12(3):251-252.
- 25. 孙宁东, 郭徐林, 李峻, 等. 乳腺囊性增生病患者预防性乳房切除的讨论[J]. 中华乳腺病杂志:电子版, 2010, 4(2):223-226.