钼靶钩丝定位在切除触诊阴性的BI-RADS Ⅳ级以上乳腺病变中的意义

李航; 苏建辉; 张颖; KumarLavneesh; 张杰; 杨帅; 张风华

doi:10.3969/j.issn.1000-8179.20141347

钼靶钩丝定位在切除触诊阴性的BI-RADS Ⅳ级以上乳腺病变中的意义

doi: 10.3969/j.issn.1000-8179.20141347

李航^{①, ②,},
苏建辉^{①, ④},
张颖^①,
KumarLavneesh^{①, ③},
张杰^{①, ②},
杨帅^{①, ②},
张风华^{①, ⑤, ,}

①.
河北省人民医院（石家庄市050051）
②.
河北医科大学研究生学院
③.
河北医科大学国际学院
④.
医学影像科
⑤.
腺体外科

详细信息

作者简介:
李航专业方向为乳腺癌基础与临床研究。E-mail：258153205@qq.com

通讯作者:
张风华 z139338@126.com

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出版历程
- 收稿日期: 2014-08-09
- 修回日期: 2014-09-19
- 刊出日期: 2020-12-29

The significance of breast mammography assisted by hook-wire localization biopsy for BI-RADS Ⅳ and above negative breast lesions

LI Hang^{①, ②
,},
SU Jianhui^{①, ④},
ZHANG Ying^①,
KUMAR Lavneesh^{①, ③},
ZHANG Jie^{①, ②},
YANG Shuai^{①, ②},
ZHANG Fenghua^{①, ⑤
, ,}

①.
Hebei General hospital, Shijiazhuang, 050051, China
②.
Graduate Students of Hebei Medical University
③.
Graduate Student from the Institute of International EducationCollege of Hebei Medical University
④.
Department of medical imaging of Hebei General Hospital, Chief Physician, Engages in the Imaging Studies of Mammary GlandDisease, Shijiazhuang, 050051, China
⑤.
The first department of general surgery(breast and thyroid department)

More Information

Corresponding author: Fenghua ZHANG; E-mail: z139338@126.com

摘要

摘要: 目的探讨乳腺钼靶X线摄影引导下钩丝定位活检技术对临床触诊阴性或触诊不良的BI-RADS Ⅳ级及以上乳腺病变的诊断意义。方法选取2012年1月至2014年8月48例乳腺钼靶BI-RADS Ⅳ级及以上但临床触诊阴性或触诊不良的乳腺病变患者（其中双侧病变4例、单侧病变44例、共计52处病灶），进行钼靶X线摄影引导下钩丝定位活检术。结果所有52处病灶中恶性病变13例（均单侧），其中0期占46.15%（6/13），Ⅰ期占38.46%（5/13），Ⅱ期占15.39%（2/13）；良性病变39例，乳腺癌检出率为25.0%。钼靶BI-RADS Ⅳ级患者中良性病变39例，恶性病变10例；BI-RADS Ⅴ级患者中良性病变0例，恶性病变3例。Ⅳ、Ⅴ级中乳腺癌的阳性检出率分别为25.6%和100%。结论钼靶辅助下钩丝定位活检可以精确切除临床触诊阴性或触诊不良的BI-RADS Ⅳ级及以上乳腺病灶，提高患者生活质量和改善预后，是一种安全、准确、费用低廉的诊断方法，值得国内临床广泛推广。
- 乳腺钼靶 /
- 触诊阴性 /
- 乳腺肿瘤 /
- 放射影像技术 /
- BI-RADS分级
Abstract: Objective To evaluate the diagnosis significance of breast mammography assisted by hook-wire localization biopsy for BI-RADS Ⅳ and above negative or non-palpable breast lesions. Methods A total of 48 cases of mammary molybdenum target with BI-RADS Ⅳ level and above but with clinical-touched negative or non-palpable breast lesions (including 4 bilateral lesions and 44 unilateral lesions; total of 52 lesions) were used in the mammography aided by hook-wire localization biopsy. Results Among the 52 lesions, 13 cases were malignant lesions (single), 6 cases were at Stage 0 (accounted for 46.15%), 5 cases were in Stage I (38.46%), and 2 cases were in Stage Ⅱ (15.39%). The remaining 39 cases were benign lesions. Results showed that the detection rate for breast cancer was 25.0%. A total of 39 cases of benign lesions and 10 cases of malignant lesions were found among mammography BI-RADS Ⅳpatients. Zero cases of benign lesions and 3 cases of malignant change were found among BI-RADS Ⅴ patients. The positive rates of breast cancer among BI-RADS Ⅳand Ⅴ patients were 25.64% and 100%, respectively. Conclusion Breast mammography assisted by hook-wire localization biopsy could precisely excise both BI-RADS Ⅳ and Ⅴ negative/non-palpable breast lesions. This technique can also improve the quality of life and prognosis of patients. It is a safe, accurate, and low-cost diagnostic method. Thus, breast mammography assisted by hook-wire localization biopsy must be widely used in clinical applications in China.
- mammary molybdenum target /
- negative or non-palpable breast lesions /
- breast neoplasms /
- radiation imaging technology /
- BI-RADS classification

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图 1 典型病例1

Figure 1. Typical case 1

A: Regular mammography cc; B: Mammography hook wire localization; C: Photographs of specimens after partial mastectomy; D: Postoperative pathological diagnosis: tubular carcinoma(H&E×100)

下载: 全尺寸图片幻灯片

图 2 典型病例2

Figure 2. Typical case 2

A: Multiple fiber adenoma formation, partial interstitial calcification; (left) typical changes of microcalcification; B: Hook wire localization to sand like microcalcification

下载: 全尺寸图片幻灯片

表 1 乳腺切检术后病理结果

Table 1. Pathological results after breast biopsy

表 2 钼靶BI-RADS分级与乳腺癌分期之间的关系（n=13）

Table 2. Relationship between mammography BI-RADS classification and breast cancer stage(n=13)

表 3 乳腺病变与钼靶BI-RADS分级（n=52）

Table 3. Breast lesions and mammography BI-RADS classification(n=52)

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