Evaluation of stereotactic core needle biopsy (SCNB) of the breast at a single institution
Evaluation of stereotactic core needle biopsy (SCNB) of the breast at a single institution
复制标题
在单一机构对乳腺立体定向核心针活检 (SCNB) 进行评估
DOI：
10.1023/a:1006449319179
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发表时间：
2000
影响因子：
3.8
通讯作者：
E. D. Paredes
中科院分区：
文献类型：
--
作者：
S. Latosinsky;D. Cornell;H. Bear;S. Karp;S. Little;E. D. Paredes
立体定向空芯针活检（SCNB）已成为一种流行的方法来诊断隐匿性乳腺异常。很少有来自单一机构的大型SCNB系列。在一所大学医院前瞻性收集了43个月内因乳腺X线摄影异常接受SCNB的患者的数据。乳腺X线检查结果分为良性、可能良性、不确定、可疑或恶性。对于非诊断性、显示非典型增生或恶性（原位或浸润性）或与活检前乳房X线检查结果不一致的SCNB病理学病变，建议手术切除。审查了随后的手术病理。SCNB后对所有剩余病变进行了乳腺X线检查。对607例患者的692处病变进行了SCNB。恶性肿瘤79例，阳性率11.4%。349例乳腺X线摄影检查为良性、可能良性和不确定病变的SCNB阳性率仅为4%。建议对127个（18.3%）病变进行手术，而565个（81.6%）在SCNB后进行了乳房X线检查。至少一次随访乳房X线检查的依从率为61%，中位随访时间为17.2个月，未发现癌症，SCNB对恶性肿瘤的敏感性为93%。SCNB提供了一种微创方法来评估乳房X线摄影异常。放射学上认为非恶性或可疑的乳腺癌很少发生癌症。在该系列中，较低的阳性SCNB率导致乳房X线摄影随访时无假阴性。SCNB的最佳阳性活检率存在争议。
Stereotactic core needle biopsy (SCNB) has become a popular method for diagnosis of occult breast abnormalities. There are few large series of SCNB from a single institution. Data on patients undergoing SCNB for mammographic abnormalities were collected prospectively over 43 months at a university hospital. Mammographic findings were categorized as benign, probably benign, indeterminate, suspicious or malignant. For lesions with SCNB pathology that were non-diagnostic, showed atypical hyperplasia or malignancy (in situor invasive), or were discordant with the pre-biopsy mammogram findings, surgical excision was recommended. Subsequent surgical pathology was reviewed. All remaining lesions were followed mammographically after SCNB. SCNB was performed on 692 lesions in 607 patients. There were 79 malignancies, for a positive SCNB rate of 11.4%. The 349 SCNB performed for benign, probably benign and indeterminate lesions on mammography had a positive SCNB rate of only 4%. Surgery was recommended for 127 (18.3%) lesions, while 565 (81.6%) were followed mammographically after SCNB. A compliance rate of 61% for at least one follow-up mammogram was obtained, with a median follow-up of 17.2 months and with no cancers found. The sensitivity for malignancy with SCNB was 93%. SCNB provides a minimally invasive method to assess mammographic abnormalities. Abnormalities considered radiographically to be other than malignant or suspicious yielded few cancers. In this series a low positive SCNB rate resulted in no false negatives on mammographic follow-up. The optimal positive biopsy rate for SCNB is debatable.