Retrospective Clinical Study Of Ultrasound-guided Vacuum Assisted Biopsy System In Diagnosis And Treatment Of Breast Diseases

Objective: Clear diagnosed by postoperative pathology were retrospectively analyzed in169 cases without nipple discharge of breast Intraductal papilloma(Intraductal papilloma,IP),10 patients with breast benign leaf tumor(Phyllodes tumor,PT),29 patients with breast cancer respectively by ultrasound guided by Vacuum aided biopsy system(Vacuum assisted biopsy,VAB)complete resection(intraoperative ultrasound evaluation of breast neoplasm no residual)whether to accept surgery again and again after operation of paraffin pathology diagnosis,To determine whether there is recurrence or histological underestimation,and combine with the BI-RADS grading of preoperative ultrasound diagnosis of breast masses,and then to explore and analyze the clinical research of vacuum-assisted biopsy system in breast diseases.Methods: between January 2014 and December 2017 in the first hospital affiliated to China medical university breast surgery under vacuum auxiliary biopsy system guided by ultrasound in 3612 patients of complete resection of the mass,the postoperative pathological diagnosis of paraffin breast intraductal papilloma(IP)with or without associated with Atypical hyperplasia of catheter(Atypical ductal hyperplasia,ADH)of202 cases of patients,patients with breast benign tumor leaf(PT)10 cases,29 patients with breast cancer were retrospectively analyzed.Among them,202 patients with intraductal papilloma(IP)of the breast were followed up,and 33 were lost to follow-up.All patients were followed up for 36 to 72 months after surgery.All patients were female,aged 19 to 68 years,and were asked about their past medical history during follow-up.Ten patients with benign lobular breast tumor(PT)were followed up for 18 to 51 months.All the patients were female,aged 18 to 54 years.Twenty-nine patients with breast cancer were followed up,and 1 case was lost to follow-up.Postoperative follow-up lasted from 13 to 58 months.All the patients were female,aged from 26 to 63 years.Clinical data were collected: general clinical data of patients,preoperative ultrasonography of tumors,postoperative paraffin pathological diagnosis,ultrasound BI-RADS classification of tumors of patients undergoing reoperation,time of reoperation,operative method of reoperation,and paraffin pathological results of reoperation.Results: 3612 patients in this study by ultrasound guided by vacuum assisted minimally invasive Xuan Qie Shu paraffin postoperative pathologic results in fiber adenoma(Fibroadenoma,FA)2490 cases(68.9%),followed by 823 cases of mammary gland disease(22.8%),breast intraductal papilloma(IP)in 202 cases(5.6%),29 cases of breast cancer(0.8%),10 cases of breast benign tumor leaf(PT)(0.3%).Among 169 patients with intraductal papilloma of the breast,45 patients(26.6%)had dysplasia(ADH)and 15patients(8.9%)had multiple intraductal papilloma(IP).Single intraductal papilloma(IP)of the breast was 109(64.5%).The reoperation rate was only 5.9%,the total recurrence rate was 3.0%,and the recurrence rate was 1.8% in patients with multiple intraductal papilloma.The recurrence rate in patients with single intraductal papilloma was 1.2%.The risk of developing breast cancer was 1.2 percent.The proportion of breast cancer patients was only 0.8%,and the detection rate of breast cancer was very low.The pathological results were mainly invasive ductal carcinoma of the breast(55.2%),and the breast-conserving rate of reoperation was 25%.There were 10 patients(0.3%)with breast lobular tumor(PT),all of whom were pathologically diagnosed as benign lobular tumor.After 30～63 months of follow-up,none of the patients underwent resurgical treatment.Among the 3612 patients,3414 cases(94.5%)were classified as BI-RADS 4A,followed by 108 cases(3%)of BI-RADS 4B,and 73 cases(2%)of BI-RADS 3,respectively.The malignant rates in the 4 categories of preoperative ultrasound of breast tumors were:BI-RADS 4A(0.4%),BI-RADS 4B(7.4%),and BI-RADS 4C(5.9%).The preoperative tumor classification of 169 patients with intraductal papilloma(IP)was classified by ultrasound BI-RADS,including 9 cases(5.3%)in category 3,143 cases(84.6%)in category 4A,and 17 cases(24.6%)in category 4B.Ultrasound BI-RADS classification of 10 patients with benign lobular breast tumor(PT)before surgery,including 3 cases of BI-RADS category 3(30%)and 7 cases of BI-RADS category 4A(70%);Preoperative tumor classification of 29 breast cancer patients with ultrasound BI-RADS,including 5 cases of BI-RADS category 3(17.2%),15 cases of BI-RADS category 4A(51.7%),8 cases of BI-RADS category 4B(27.6%),and 1 case of BI-RADS category 4C(3.4%).CONCLUSIONS: Vacuum-assisted biopsy system has high diagnostic value for breast diseases on the basis of complete resection of breast masses.The system can be applied to complete resection of breast masses diagnosed as BI-RADS 4A class and part of BI-RADS 3 class by ultrasound preoperatively.For BI-RADS 4B breast masses,the main function of the vacuum-assisted biopsy system is to perform biopsy pathology on the basis of removing the tumor as completely as possible.For high-risk lesions such as isolated intraductal papilloma(IP)and benign lobular tumor(PT)without nipple discharge,close imaging follow-up can be performed after minimally invasive vacuum rotation surgery.