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目的探讨超声引导导丝置入定位技术在乳腺触诊阴性肿块微创切除术的应用价值。方法回顾性分析乳腺触诊阴性肿块微创手术切除前进行了超声引导乳腺导丝置入定位技术的377例患者403个肿块的影像和病历资料,统计分析肿块大小、肿块位置、肿块良恶性、病理类型、恶性肿块病理TNM分期、定位成功率、肿块完全切除率等。结果 403个肿块全部被完整切除,且术中证实定位全部成功,定位成功率为100%;肿块平均直径为(10.1±5.1)mm,其中恶性肿块平均直径为(12.5±6.0)mm,良性肿块平均直径为(9.9±5.0)mm,两者间差异有统计学意义(P=0.008)。194个(48.14%)肿块位于外上象限,82个(20.35%)肿块位于内上象限,75个(18.61%)肿块位于外下象限,38个(9.43%)肿块位于内下象限,13个(3.22%)肿块位于中央区;1个(0.25%)肿块位于胸壁深面肌间,病理学检查证实为淋巴结。病理类型:恶性肿块31个(7.69%);良性肿块372个(92.31%),其中高危肿块60个(16.13%),淋巴结1个,病理结果为反应性增生淋巴结。结论超声引导下导丝置入定位技术可以辅助外科医师精准微创切除临床触诊困难的乳腺小肿块。
Objective To investigate the value of ultrasound-guided guide wire placement in minimally invasive resection of negative mass in palpation of breast. Methods Retrospective analysis of minimally invasive breast tumor palpation before resection of the ultrasound-guided breast guide wire positioning technique of 377 patients with 403 lumps of images and medical records, statistical analysis of tumor size, mass location, the benign and malignant mass, Pathological type, TNM staging of malignant tumor, successful localization rate, complete resection rate of tumor and so on. Results All 403 lumps were completely resected, and all the resections were successful in operation. The successful rate was 100%. The mean diameter of lumps was (10.1 ± 5.1) mm, and the average diameter of malignant lumps was (12.5 ± 6.0) mm. The average diameter was (9.9 ± 5.0) mm, the difference was statistically significant (P = 0.008). 194 (48.14%) masses were in the upper quadrant, 82 (20.35%) masses were in the upper quadrant, 75 (18.61%) masses were in the lower quadrant, 38 (9.43%) masses were in the inferior quadrant, and 13 (3.22%) in the central area; 1 (0.25%) in the deep musculature of the chest wall, pathologically confirmed as lymph nodes. Pathological types: 31 (7.69%) malignant masses; 372 (92.31%) benign masses, including 60 high-risk mass (16.13%) and 1 lymph node. The pathological results were reactive hyperplastic lymph nodes. Conclusion Ultrasound-guided guide wire positioning technique can help surgeons to accurately and minimally invasive removal of small palpable breast masses in clinical palpation.