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目的探讨术前乳腺X线引导下行导丝穿刺定位切除乳腺钙化灶在乳腺疾病诊疗中的临床应用价值。方法对63例乳腺病患者,临床触诊阴性、彩超阴性但乳腺X线摄片发现异常表现的钙化病灶,术前行乳腺X线导丝穿刺定位,术中病灶切除活检,确定病灶的病理类型。结果 63例异常钙化灶病例中,浸润性乳腺癌11例(17.5%)、乳腺导管原位癌6例(9.5%)、不典型增生13例(20.6%)、乳腺纤维腺瘤28例(44.4%)、其他良性病变5例(7.9%)。并且病理结果与钙化灶的形态与分布特点具有相关性,表现为不定形、不均质、成簇分布或线样分支状的钙化灶提示恶性程度高,需要临床进一步活检或者手术治疗。结论乳腺X线引导下导丝穿刺定位切除钙化灶具有组织创伤小,定位准确,安全可靠等特点,提高乳腺癌的早期诊断,对改善乳腺癌患者的预后和生存有重要意义。
Objective To investigate the clinical value of preoperative breast X-ray guided guide wire puncture in removal of breast calcification in the diagnosis and treatment of breast disease. Methods 63 cases of breast disease, clinical palpation negative, color Doppler ultrasound but mammography found abnormal calcification lesions, preoperative breast X-ray guide wire positioning, intraoperative lesion biopsy to determine the pathological type of lesions . Results Of the 63 cases with abnormal calcification, 11 cases (17.5%) had invasive breast cancer, 6 cases (9.5%) had ductal carcinoma in situ, 13 cases (20.6%) had atypical hyperplasia and 28 cases (44.4 cases) had breast fibroadenoma %), Other benign lesions in 5 cases (7.9%). And pathological findings and calcification of the shape and distribution characteristics are related to the performance of the amorphous, heterogeneous, clustered distribution or line-like calcification suggest that high degree of malignancy, the need for clinical further biopsy or surgical treatment. CONCLUSION: The guide wire guided by the guideline of the breast under the guidance of the guide wire for the removal of calcification has the advantages of less tissue trauma, accurate positioning and safety and reliability. It is of great significance to improve the early diagnosis of breast cancer and improve the prognosis and survival of patients with breast cancer.