Application of Ultrasound-guided Wire Localization in Surgical Excision of Non-palpable Breast Lesions_West China Medical Journal

Authors：

MA Buyun , LAN Lin , LIANG Li ,  PENG Yulan , CHEN Qirui

Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

PENG Yulan, Email: ws_mby@126.com

Keywords：

乳腺病灶; 超聲引導; 導絲定位; 手術

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【摘要】　目的　探討超聲引導下導絲定位在不可觸及的乳腺病灶切除中的應用價值。　方法　對2005年1月－2010年9月127例女性患者的137個乳腺病灶（臨床捫診均為陰性），在超聲引導下進行導絲定位，后進行外科切除活檢，并對相關資料進行回顧性分析。　結果　 137個病灶的組織學結果中，良性病灶101個（73.7%）、高風險病灶27個（19.7%）和癌9個（6.6%）。9個癌中3個為導管原位癌，6個為浸潤性導管癌（大小11～19 mm，平均14.2 mm）。超聲引導下導絲定位的時間為3～15 min，平均6 min；無血腫、導絲脫落及折斷等并發癥發生。外科手術切除時間20～40 min，平均30 min。　結論　超聲引導下進行導絲定位安全、迅速，能協助外科手術進行準確的活檢和切除。
【Abstract】　Objective　 To determine the application value of ultrasound-guided wire localization in surgical excision of non-palpable breast lesions.　Methods　 Between January 2005 and September 2010, 127 women with 137 non-palpable breast lesions underwent surgical excision at West China Hospital. Palpation results for all the lesions were negative. Wire localization guided by ultrasound was performed before operation and biopsy. Related imaging studies and medical records were reviewed retrospectively.　Results　 Histological findings showed there were 101 benign lesions (73.7%), 27 high-risk lesions (19.7%), and 9 carcinomas (6.6%). Among the 9 carcinomas, 3 were ductal carcinoma in situ, and 6 were infiltrating carcinoma (with their size ranged from 11 to 19 mm averaging at 14.2 mm). The time of performing ultrasound-guided wire localization was from 3 to 15 minutes averaging at 6. No complications like hematoma, wire fragments, and wire breakage occurred in all cases. The surgical excision time ranged from 20 to 40 minutes averaging at 30.　Conclusions　 Ultrasound-guided wire localization can be performed quickly and safely for the cases of non-palpable breast lesions. It is useful in assisting surgical excision and biopsy.

Citation： MA Buyun,LAN Lin,LIANG Li,PENG Yulan,CHEN Qirui. Application of Ultrasound-guided Wire Localization in Surgical Excision of Non-palpable Breast Lesions. West China Medical Journal, 2011, 26(7): 986-988. doi: Copy

1.	Henrietta B, Eva S, Eniko N. The treatment of non-palpable breast tumors found during mammographic screening at our hospital[J]. Magy Seb, 2005, 58(3): 162-166.
2.	Köhler J, Krause B, Grunwald S, et al. Ultrasound and mammography guided wire marking of non-palpable breast lesions: analysis of 741 cases[J]. Ultraschall Med, 2007, 28(3): 283-290.
3.	李宏江, 敬靜, 馬步云, 等. 彩超引導下穿刺鋼絲標記定位對無體征乳腺癌的診斷價值[J]. 四川大學學報(醫學版), 2007, 38(2): 358-359.
4.	Houssami N, Iwig L, Simpson J, et al. Sydney Breast Imaging Accuracy Study: comparative sensitivity and specificity of mammography and sonography in young women with symptoms[J]. Am J Roentgenol, 2003, 180(4): 935-940.
5.	陳麗羽, 錢超文, 徐棟, 等. 超聲引導細針定位在乳腺隱匿性病灶切除中的應用[J]. 臨床超聲醫學雜志, 2006, 12(8): 724-726.
6.	Ki Yeol Lee, Bo Kyoung Seo, Ann Yi, et al. Immersion ultrasonography of excised nonpalpable breast lesion specimens after ultrasound-guided needle localization[J]. Korean J Radiol, 2008, 9(4): 312-319.
7.	梁曉寧, 郭瑞君, 鞏麗煥, 等. 超聲引導乳腺定位導絲置入在觸診陰性乳腺微鈣化病變中的應用[J]. 中國醫學影像技術, 2011, 27(5): 979-981.
8.	李艷萍, 高宏, 王慧宇, 等. 不能觸及腫塊的乳腺腫瘤超聲引導下導絲定位活檢[J]. 中國實用外科雜志, 2009, 29(10): 853-855.
9.	Liberman L, Kaplan J, van Zee KJ, et al. Bracketing wires for preoperative breast needle localization[J]. AJR Am J Roentgenol, 2001, 177(3): 565-572.
10.	姜玉新, 榮雪余, 孫強, 等. 乳腺腫塊的術前超聲引導定位[J]. 中華超聲影像學雜志, 2000, 9(11): 646-647.
11.	Bouton ME, Wilhelmson KL, Komenaka IK. Intraoperative ultrasound can facilitate the wire guided breast procedure for mammographic abnormalities[J]. Am Surg, 2011, 77(5): 640-646.
12.	Rissanen TJ, Mäkäräinen HP, Mattila Sl, et al. Wire localized biopsy of breast lesions: a review of 425 cases found in screening or clinical mammography[J]. Clin Radiology, 1993, 47(1): 14-22.
13.	Haffty BG, Lee C, Philpotts L, et al. Prognostic significance of mammographic detection in a cohort of conservatively treated breast cancer patients[J]. Cancer J Sei Am, 1998, 4(1): 35-40.
14.	Choo KS, Kwak HS, Tae Bae Y, et al. The value of a combination of wire localization and ultrasound-guided vacuum-assisted breast biopsy for clustered microcalcifications[J]. Breast, 2008, 17(6): 611-616.
15.	Costa A, Zanini V. Precancerous lesions of the breast[J]. Nat Clin Pract Oncol, 2008, 5(12): 700-704.

1. 　Henrietta B, Eva S, Eniko N. The treatment of non-palpable breast tumors found during mammographic screening at our hospital[J]. Magy Seb, 2005, 58(3): 162-166.
2. 　Köhler J, Krause B, Grunwald S, et al. Ultrasound and mammography guided wire marking of non-palpable breast lesions: analysis of 741 cases[J]. Ultraschall Med, 2007, 28(3): 283-290.
3. 　李宏江, 敬靜, 馬步云, 等. 彩超引導下穿刺鋼絲標記定位對無體征乳腺癌的診斷價值[J]. 四川大學學報(醫學版), 2007, 38(2): 358-359.
4. 　Houssami N, Iwig L, Simpson J, et al. Sydney Breast Imaging Accuracy Study: comparative sensitivity and specificity of mammography and sonography in young women with symptoms[J]. Am J Roentgenol, 2003, 180(4): 935-940.
5. 　陳麗羽, 錢超文, 徐棟, 等. 超聲引導細針定位在乳腺隱匿性病灶切除中的應用[J]. 臨床超聲醫學雜志, 2006, 12(8): 724-726.
6. 　Ki Yeol Lee, Bo Kyoung Seo, Ann Yi, et al. Immersion ultrasonography of excised nonpalpable breast lesion specimens after ultrasound-guided needle localization[J]. Korean J Radiol, 2008, 9(4): 312-319.
7. 　梁曉寧, 郭瑞君, 鞏麗煥, 等. 超聲引導乳腺定位導絲置入在觸診陰性乳腺微鈣化病變中的應用[J]. 中國醫學影像技術, 2011, 27(5): 979-981.
8. 　李艷萍, 高宏, 王慧宇, 等. 不能觸及腫塊的乳腺腫瘤超聲引導下導絲定位活檢[J]. 中國實用外科雜志, 2009, 29(10): 853-855.
9. 　Liberman L, Kaplan J, van Zee KJ, et al. Bracketing wires for preoperative breast needle localization[J]. AJR Am J Roentgenol, 2001, 177(3): 565-572.
10. 　姜玉新, 榮雪余, 孫強, 等. 乳腺腫塊的術前超聲引導定位[J]. 中華超聲影像學雜志, 2000, 9(11): 646-647.
11. 　Bouton ME, Wilhelmson KL, Komenaka IK. Intraoperative ultrasound can facilitate the wire guided breast procedure for mammographic abnormalities[J]. Am Surg, 2011, 77(5): 640-646.
12. 　Rissanen TJ, Mäkäräinen HP, Mattila Sl, et al. Wire localized biopsy of breast lesions: a review of 425 cases found in screening or clinical mammography[J]. Clin Radiology, 1993, 47(1): 14-22.
13. 　Haffty BG, Lee C, Philpotts L, et al. Prognostic significance of mammographic detection in a cohort of conservatively treated breast cancer patients[J]. Cancer J Sei Am, 1998, 4(1): 35-40.
14. 　Choo KS, Kwak HS, Tae Bae Y, et al. The value of a combination of wire localization and ultrasound-guided vacuum-assisted breast biopsy for clustered microcalcifications[J]. Breast, 2008, 17(6): 611-616.
15. 　Costa A, Zanini V. Precancerous lesions of the breast[J]. Nat Clin Pract Oncol, 2008, 5(12): 700-704.

West China Medical Journal

Application of Ultrasound-guided Wire Localization in Surgical Excision of Non-palpable Breast Lesions

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