【摘要】 背景与目的:随着乳腺影像技术的进步和推广,临床触诊未发现乳腺肿块而影像学检查发现高度可疑恶性病灶者越来越多。本研究旨在探讨乳腺钼靶立体定位美蓝染色引导切除活检对诊治这一类病灶的意义。方法:选取2002年8月至2006年10月中山大学肿瘤防治中心在临床触诊不到肿块而影像学检查发现高度可疑恶性乳腺病灶的患者138例。术前,在钼靶立体定位引导下注射少量美蓝到可疑病灶。以乳头为参照确定活检切口,将蓝染的乳腺组织切除。标本切除后,行标本钼靶照片并与原乳腺片对照,以确定切除的准确性。然后,按病理结果作相应处理。结果:全组138例患者通过上述方法均将可疑病灶准确切除。经病理检查84例(60.9%)诊断为乳腺癌,54例(39.1%)为良性病变。手术切口平均长度4.3cm,切除标本平均重量为42g。全组病例的切口均Ⅰ期愈合。结论:对临床上无乳腺肿块而影像学检查发现高度可疑恶性的病灶应行切除活检。钼靶立体定位美蓝染色引导切除活检是一种准确率高、创伤性小且简单、价廉的方法,值得推广。更多还原

【Abstract】 Background and Objective: With advances in mammographic equipment and technique, more and more nonpalpable breast lesions have been detected. This study was to investigate the application of methylene blue dye for localized biopsy to diagnose nonpalpable breast lesions. Methods: In total 138 patients with suspicious malignant, nonpalpable breast lesions between Aug. 2002 and Oct. 2006 were enrolled. A small dose of methylene blue was injected into the lesion under mammographic guidance. The dyed tissues were excised completely via an optimal incision, and radiographys was obtained to confirm the removal of the nonpalpable lesion. The specimen weight and incision length were evaluated. Results: Suspicious lesions in all 138 patients were accurately excised. Breast cancer was confirmed in 84 lesions (60.9%), and benign lesions in 54 lesions. The mean length of the incision was 4.6 cm (range 3.2-5.3 cm), and the mean weight of the resected specimen was 42 g (range18-86 g). All patients achieved stage I healing. Conclusions: Biopsy is recommended for nonpalpable breast lumps which are highly suggestive of malignancy by imaging examination. Methylene blue guided localization and excisional biopsy is a safe, relatively simply procedure with high diagnostic accuracy更多还原