Ultrasound Guided Therapeutic Excisional Vacuum Assisted Biopsy in Breast Fibroadenomas.

Onur Buğdaycı, Handan Kaya, Erkin Arıbal
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Abstract

Objective: The aim of this study was to evaluate the performance of ultrasound (US) guided Vacuum Assisted Biopsy (VAB) in the therapeutic excision of breast fibroadenomas.

Materials and methods: Patients who underwent excisional US guided VAB of their fibroadenomas between December 1999-May 2001 were retrospectively evaluated. Seventy-eight patients with BI-RADS category 3 and 4a lesions (one lesion per patient) with a maximum diameter smaller than 3 cm were enrolled in the study. Fifty-one of those were diagnosed with fibroadenoma. Biopsies were performed with a 11G needle using the Mammotome (Johnson & Johnson, New Jersey, USA) vacuum biopsy device. Patients were followed up with US for three years. Follow-ups were done semiannually in the first year and annually afterwards.

Results: Ten patients (19%) were found to have residual lesions in the first week after the biopsy. Additional eight patients (15%) were found to have residual-recurrent lesions in their annual follow up. However, none of these eight lesions demonstrated growth during the three year follow-up. The initial size of the FA was not found to be significantly different between the lesions which were completely excised with no residue or recurrence and those which were not (p>0.05).

Conclusion: The VAB method for the therapeutic excision of small FAs or other benign lesions is practical and easily tolerated by patients. Lesions smaller than 3 cm should be preferred for VAB. A multidisciplinary clinical environment is necessary for each step of the treatment.

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超声引导下的乳腺纤维腺瘤治疗性切除真空辅助活检术
研究目的本研究旨在评估超声(US)引导下真空辅助活检术(VAB)在治疗性切除乳腺纤维腺瘤中的表现:回顾性评估了 1999 年 12 月至 2001 年 5 月期间在 US 引导下对乳腺纤维腺瘤进行切除术的患者。78例 BI-RADS 3 类和 4a 类病变(每位患者一个病变)且最大直径小于 3 厘米的患者被纳入研究。其中 51 人被诊断为纤维腺瘤。活检使用 11G 的针头和 Mammotome(强生公司,美国新泽西州)真空活检设备进行。对患者进行了为期三年的 US 随访。第一年每半年随访一次,之后每年随访一次:结果:10 名患者(19%)在活检后第一周发现有残留病灶。另有八名患者(15%)在每年的随访中被发现有残留复发病灶。不过,在三年的随访中,这八名患者的病灶都没有增大。在完全切除且无残留或复发的病灶与未完全切除的病灶之间,FA 的初始大小没有明显差异(P>0.05):结论:用 VAB 法治疗性切除小的 FA 或其他良性病变是实用的,患者也容易接受。小于 3 厘米的病变应首选 VAB。治疗的每个步骤都需要一个多学科的临床环境。
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