■美国国家外科辅助乳腺和肠道项目(NSABP)B32试验报道,芯针活检(CNB)对前哨淋巴结的检出率高于节段性切除术。然而,关于真空辅助乳腺活检(VABB)前哨淋巴结检出率的报道很少.因此,我们分析了术前活检方法对我们中心3,966例乳腺癌患者手术方式的影响.
■总共,3,966名女性乳腺癌患者[临床肿瘤淋巴结转移(TNM)I-III期]被纳入本研究。术前病理诊断方法包括细针穿刺活检(FNA),CNB,切除活检,和VABB。根据诊断时间。数据经卡方检验分析,SPSS22.0中的方差分析和Kaplan-Meier时间序列。
■随着时间的推移,接受切除活检(7.3%至2.7%)和术中冷冻(89.4%至28.9%)的患者数量有所减少,而CNB呈增加趋势(1.6%至55.3%)。VABB的阳性率,CNB,切除活检,FNA为99.5%,97.1%,97.9%,和82.2%,分别,假阴性率为0%,1.8%,0.34%,和8.9%,分别。整体保乳率为36.7%,而VABB的保乳率为57.1%。cN0患者腋窝前哨淋巴结活检率为48.3%,术中冰冻组(36.7%)和切除活检组(39.5%)均低于CNB组(57.1%)和VABB组(77.9%)。截至2019年12月,共有350例肿瘤复发或转移。活检方法与累积生存时间无关。
■乳腺癌诊断和治疗的变化对肿瘤活检的方法产生了深远的影响。VABB活检提供的优势,如准确的诊断,一次采集更大体积的组织,微创和可重复,不影响患者的手术方式和预后。它将逐步成为乳腺癌术前病理评价的主要办法。
UNASSIGNED: The National Surgical Adjuvant Breast and Bowel Project (NSABP) B32 trial reported that the detection rate of sentinel lymph nodes by core needle biopsy (CNB) is higher than that by segmental resection. However, there are few reports regarding the detection rate of sentinel lymph nodes by vacuum-assisted breast biopsy (VABB). Therefore, we analyzed the impact of preoperative biopsy methods on the surgical modes of 3,966 patients with breast cancer in our center.
UNASSIGNED: In total, 3,966 female breast cancer patients [clinical tumor node metastasis (TNM) stage I-III] were enrolled in this study. Preoperative pathological diagnosis methods included fine needle aspiration (FNA) biopsy, CNB, excision biopsy, and VABB. According to the time of diagnosis. The data were analysis by chi square test, variance analysis and the Kaplan-Meier time series in SPSS 22.0.
UNASSIGNED: There was a decrease in the number of patients that underwent excision biopsy (7.3% to 2.7%) and intraoperative freezing (89.4% to 28.9%) over time, while CNB exhibited an increasing trend (1.6% to 55.3%). The positive rates of VABB, CNB, excision biopsy, and FNA were 99.5%, 97.1%, 97.9%, and 82.2%, respectively, and the false negative rates were 0%, 1.8%, 0.34%, and 8.9%, respectively. The overall breast-conserving rate was 36.7%, while the breast-conserving rate for VABB was 57.1%. The axillary sentinel lymph node biopsy rate of cN0 patients was 48.3%, and the intraoperative frozen group (36.7%) and excision biopsy group (39.5%) were lower than the CNB (57.1%) and VABB (77.9%) groups. Until December 2019, there were 350 cases with tumor recurrence or metastasis. The methods of biopsy were not correlated to the cumulative survival time.
UNASSIGNED: Changes to the diagnosis and treatment of breast cancer has a profound impact on the method of tumor biopsy. VABB biopsy offers advantages such as accurate diagnosis, a greater volume of tissue taken at one time, minimally invasive and repeatable, and does not affect the surgical approach and prognosis of patients. It will gradually become the primary method of preoperative pathological evaluation of breast cancer.