The clinical application value of core needle biopsy guided by fully digital mammography threeGdimensional positioning system in the diagnosis of breast lesions / 实用放射学杂志

ABSTRACT

Objective To explore the clinical application value of core needle biopsy guided by fully digital mammography three-dimensional positioning system in the diagnosis of breast lesions.Methods A retrospective analysis of 21 patients who underwent guided core needle biopsy in a fully digital mammography system was performed.2 1 patients had 2 1 lesions,which included mass (4 cases),suspected calcification (15 cases)and glandular collection (2 cases)based on X-ray examination before biopsy.The needle depth was manually calculated according to the mammogram (0°and 90°),and automatically calculated with the full digital mammography three-dimensional positioning system. The needle depth was adjusted according to the combination of above two values with the patient’s skin elasticity and gland structure. After putting a small incision into the needle with local anesthesia,X-ray radiography was taken to observe the position of the puncture needle, and then the puncture gun was excited to take out the tissue at different positions of the lesion.Finally,X-ray radiography of the tissue was performed.Results 21 patients underwent biopsy with the average operation time of 45 minutes and puncture time of 25 minutes.The needle depth adjustment range was 3－5 mm,using 14G puncture needle and 4－8 pieces of tissue were pierced according to the lesions. X-ray radiographywas performed on the removed tissue strips. For all the cases of suspected calcification,the calcified lesions were found in the removed tissue strips.No serious adverse reactions occurred in 21 patients with lateral position (1 9 cases)and sitting position (2 cases).2 patients with sitting position developed dizziness, nausea,and palpitation,and recovered quickly after rest and psychological comfort.Puncture pathology confirmed 6 cases of breast cancer (1 case of intraductal papillary carcinoma,2 cases of ductal carcinoma in situ,3 cases of invasive breast cancer),and 1 5 cases of benign lesions,with no obvious changes after one year follow-up.Conclusion In the core needle biopsy guided by the fully digital mammography three-dimensional positioning system for breast lesions,the patient should be placed in the lateral position, which can effectively reduce the occurrence of adverse reactions.A 14G puncture needle and ≥4 tissue strips can achieve a higher pos-itive rate.The technology is simple and easy to perform with a high puncture accuracy,and has important application value.