目的

探讨超声检查BI-RADS 3 级的乳腺不可扪及病变(nonpalpable breast lesion, NPBL)微创活组织检查(活检)的临床价值。

方法

回顾性分析2007 年1月至2010 年12 月在本院接受微创活检、超声BI-RADS 3 级的542 例NPBL 病例的临床、影像及病理资料,采用卡方检验比较即时活检组(首次超声诊断后3 个月之内活检)与随访活检组(随访6 个月后活检)发现恶性病变的概率以及两组恶性肿瘤情况的差异。

结果

全组542 例病例,病理确诊恶性病变5 例,总体恶性率为0.92%(5/542);50 ～59 岁患者的恶性率为9.68%(3/31),明显高于其他年龄组(20 ～29 岁组0,30 ～39 岁组0.40%,40 ～49 岁组0.57%,60 ～71 岁组0)。 即时活检组中恶性病变4例,恶性率为0.91%(4/435);随访活检组中恶性病变1 例,恶性率为0.93%(1/107),两者差异无统计学意义(P＞0.05),且两组发现的恶性肿瘤的病灶大小,TNM 分期相似。

结论

超声检查BI-RADS 3 级的NPBL 恶性率低,随访活检是安全的。 但对于年龄50 岁及以上,超声评估为BI-RADS 3 级的患者需提高警惕,建议积极进行活检。

Objective

To investigate the clinical significance of ultrasound-guided vacuum-assisted biopsy for BI-RADS grade 3 nonpalpable breast lesion (NPBL).

Methods

The clinical, imaging and histopathologic data of 542 cases of NPBL classified as grade 3 in BI-RADS and undergoing vacuum-assisted ultrasound-guided biopsy in our hospital from January 2007 to December 2010 were retrospectively analyzed. The patients were divided into group A (biopsy within 3 months after first ultrasonic diagnosis) and group B (biopsy after 6-month follow-up). The malignant rates and tumor stage were compared between the two groups.

Results

In all 542 patients, 5 were proved to be malignant (0.92%). The malignant rate in the age group of 50-59 years was 9.68%(3/31), which was significantly higher than that in other age groups (20-29 years, 0; 30-39 years, 0.40%;40-49 years,0.57%;60-71 years,0). Four patients presented malignant lesion (0.91%) in group A,1 patient (0.93%) in group B, and no significant difference was showed between the two groups(P＞0.05). Malignant cases in two groups showed similar tumor size and TNM stage.

Conclusions

NPBL of BI-RADS grade 3 has low malignant rate and biopsy in follow-up is safe for those patients. However, more attention should be paid for the patients ≥50 years with BI-RADS grade 3 NPBL and clinical biopsy is recommended.