本文選題：真空輔助活檢 + 乳腺癌��； 參考：《中國臨床醫(yī)學》2016年06期

【摘要】：目的:探討超聲引導下真空輔助活檢(vacuum-assisted biopsy,VAB)切除乳腺癌腫塊后保乳手術的可行性與安全性。方法:選擇2008年1月至2014年12月VAB腫塊切除術后行保乳手術治療的45例浸潤性導管癌(invasive ductal carcinoma,IDC)患者(VAB組)。選取同一時期單發(fā)、直徑小于2cm、腫塊切除活檢后行保乳手術的147例IDC患者為對照組。分析并比較兩組患者的臨床病理特征與預后。結果:VAB組腫塊均單發(fā)、直徑2cm且不可觸及,影像學檢查誤診為良性。所有VAB手術只行1次穿刺,穿刺點距離腫塊的平均距離為(2.52±0.89)cm。中位切割8次,影像學檢查示完全切除,平均手術時間(25.4±7.6)min,術中未發(fā)生活動性出血。保乳手術距VAB術平均(4.50±0.92)d;局部擴大切除病灶的各個切緣均陰性;無患者發(fā)生腫瘤細胞針道或皮膚穿刺點種植;3例殘腔殘留少量導管原位癌病灶,但無浸潤性癌灶。VAB組與對照組平均年齡、年齡構成、腫塊直徑、腫瘤組織學分級、脈管侵犯、淋巴結分期、前哨淋巴結陽性率、腫瘤分子分型及輔助治療、腋窩手術差異均無統(tǒng)計學意義。兩組間5年無病生存期(disease-free survival,DFS)和5年總生存期(overall survival,OS)差異均無統(tǒng)計學意義。結論:VAB切除不可觸及的較小乳腺癌腫塊后續(xù)行保乳手術安全可行,值得進一步大樣本研究。
[Abstract]:Objective: to investigate the feasibility and safety of vacuum assisted biopsy (VAB-assisted biopsyn VAB-assisted breast conserving operation) after breast cancer mass resection under ultrasound guidance. Methods: from January 2008 to December 2014, 45 VAB patients with invasive ductal carcinoma were treated with breast conserving surgery. A total of 147 IDC patients with a diameter of less than 2 cm in the same period and breast conserving operation after resection and biopsy were selected as control group. The clinicopathological features and prognosis of the two groups were analyzed and compared. Results the tumors in the VAB group were single and untouchable in diameter 2cm, and were misdiagnosed as benign by imaging examination. All VAB operations were performed only once, and the average distance from the puncture point to the mass was 2.52 鹵0.89 cm. The average operative time was 25.4 鹵7.6 min. There was no active bleeding during the operation. The average distance from breast conserving operation to VAB operation was 4.50 鹵0.92d; all incisal margins of local enlarged resection were negative; no tumor cell needle or skin puncture site implantation occurred in 3 cases of residual ductal carcinoma in situ. However, the mean age, age composition, tumor diameter, tumor histological grade, vascular invasion, lymph node staging, sentinel lymph node positive rate, tumor molecular classification and adjuvant therapy were observed in the VAB group and the control group. There was no significant difference in axillary surgery. There was no significant difference in 5 year disease-free survival (DFS) and 5 year total survival survival between the two groups. Conclusion it is safe and feasible to perform breast conserving surgery for small breast cancer masses which can not be touched by VAB resection, and it is worthy of further study in large samples.
【作者單位】： 復旦大學附屬婦產科醫(yī)院乳腺外科;
【分類號】：R737.9

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