乳腺癌真空辅助旋切术后保乳手术的可行性

发布时间：2018-04-29 02:12

本文选题：真空辅助活检 + 乳腺癌　；参考：《中国临床医学》2016年06期

【摘要】：目的:探讨超声引导下真空辅助活检(vacuum-assisted biopsy,VAB)切除乳腺癌肿块后保乳手术的可行性与安全性。方法:选择2008年1月至2014年12月VAB肿块切除术后行保乳手术治疗的45例浸润性导管癌(invasive ductal carcinoma,IDC)患者(VAB组)。选取同一时期单发、直径小于2cm、肿块切除活检后行保乳手术的147例IDC患者为对照组。分析并比较两组患者的临床病理特征与预后。结果:VAB组肿块均单发、直径2cm且不可触及,影像学检查误诊为良性。所有VAB手术只行1次穿刺,穿刺点距离肿块的平均距离为(2.52±0.89)cm。中位切割8次,影像学检查示完全切除,平均手术时间(25.4±7.6)min,术中未发生活动性出血。保乳手术距VAB术平均(4.50±0.92)d;局部扩大切除病灶的各个切缘均阴性;无患者发生肿瘤细胞针道或皮肤穿刺点种植;3例残腔残留少量导管原位癌病灶,但无浸润性癌灶。VAB组与对照组平均年龄、年龄构成、肿块直径、肿瘤组织学分级、脉管侵犯、淋巴结分期、前哨淋巴结阳性率、肿瘤分子分型及辅助治疗、腋窝手术差异均无统计学意义。两组间5年无病生存期(disease-free survival,DFS)和5年总生存期(overall survival,OS)差异均无统计学意义。结论:VAB切除不可触及的较小乳腺癌肿块后续行保乳手术安全可行,值得进一步大样本研究。
[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 卤0.89 cm. The average operative time was 25.4 卤7.6 min. There was no active bleeding during the operation. The average distance from breast conserving operation to VAB operation was 4.50 卤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.
【作者单位】：复旦大学附属妇产科医院乳腺外科;
【分类号】：R737.9

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