微创旋切术对直径小于lcm的乳腺病灶的诊断治疗价值［摘要］目的：探讨在超声引导下利用EnCorM空辅助旋切系统的微创旋切术在乳腺直径小于1cm、不可触及的肿物的诊断和治疗中的价值。方法：2010年8月〜2011年4月对我院150例直径小于1cm、不可触及的乳腺肿物患者的285个肿物在超声引导下进行EnCor微创旋切术，通过回顾性分析来评价其在乳腺直径小于lcm、不可触及的肿物的诊断和治疗中的应用价值。结果：全部乳腺肿物均采用微创旋切术，术后病理学诊断:浸润性导管癌2例，导管内癌3例，不典型增生9例，乳头状瘤12例，余均为良性。2例浸润性导管癌接受外科手术及辅助治疗。3例导管内癌，9例不典型增生及12例乳头状瘤接受外科开放手术。术后无切口瘢痕，乳房外形正常，皮肤触觉无变化。术后无一例活动性出血或创口感染，皮下瘀血6例，血肿形成6例。术后3个月行超声随访无一例复发。结论：超声引导下利用EnCor真空辅助旋切系统的微创旋切术可准确活检或完整切除乳腺直径小于1cm、不可触及的病灶，能弥补传统开放手术活检对该类乳腺病灶诊断治疗上的不足。［关键词］微创旋切术；乳腺病灶；诊断；治疗［中图分类号］R737.9［文献标识码］B［文章编号］1673-7210(2011)12(a)-166-03Thevalueofdiagnosisandtreatmentofminimallyinvasivesurgeryforbreastlesionslessthan1cmindiameterCHENJishang,CHENGuichou,FENGYushanDepartmentofBreastSurgery,thePeopledHospitalofYangjiangCity,GuangdongProvinee,Yangjiang529500,China［Abstract］Objective:Toexplorethevalueofdiagnosisandtreatmentofminimallyinvasivesurgeryforbreastlesionslessthan1cmindiameterbytheuseofEnCorsystemundertheguidaneeofultrasouncl.Methods:FromAugust2010toApril2011,285massesof150patientsinourhospitalwithbreastlesionslessthan1cmindiameterunderwentminimallyinvasivesurgerywithEnCorsystemunderultrasoundguided・Througharetrospectiveanalysis,thevalueofdiagnosisandtreatmentofminimallyinvasivesurgeryforbreastlesionslessthan1cmindiameterwasevaluated・Results:Allofbreastmasseshavebeenremovedbyminimallyinvasivesurgery.Inpostoperativepathologicaldiagnosis,2caseswereinvasiveductalcarcinoma,3caseswereductalcarcinomainsitu,9caseswereatypicalhyperplasia,12caseswereintraductalpapilloma,therestwerebenign.2casesofinvasiveductalcarcinomaweretreatedbysurgicaloperationandadjuvanttherapy・3casesofductalcarcinoma,9casesofatypicalhyperplasiaand12casesofpapillarytumorsweregivenopensurgicaloperation.Withoutpostoperativeincisionscar,thebreastmaintainedthenormalcontour.Therewasnochangeskinsensitivityandnoactivebleedingorwoundinfectioninallpostoperativepatients,subcutaneousecchymosisin6cases,hematomain6cases・Norecurrencewasfoundafter3monthsoffollow-upbyultrasonic.Conelusion:Inaccessiblebreastlesionslessthan1cmindiametercanbebiopsyaccuratelyorcompletelyremovalcompletelybyminimallyinvasivesurgerywithEnCorsystemundertheguidaneeofultrasoundandminimallyinvasivesurgerycanmakeupfortheshortfallofthetraditionalopenoperationbiopsyforthediagnosisandtreatmentofthiskindofbreastlesions・[Keywords]Minimallyinvasivesurgery;Breastlesions;Diagnosis;Treatment随着影像诊断设备的改进与技术的提高，人们防癌意识的增强及健康普查的开展，查体时发现乳腺直径小于lcm＞不可触及的隐匿性病变逐年增多，并确有不少患者在活检时发现不典型增生甚至早期微小癌[1],因此应该重视对该类病灶的活检及切除，以便及时对早期癌变的诊断治疗及癌前病变的彻底治疗，从而提高乳腺癌总体治愈率。但针对乳腺不可触及的肿物在采取传统开放手术活检时较为困难，无法准确获取标本。2002年Fine等⑵描述在超声引导下运用真空辅助系统（Mammotome活检系统）连续获取组织标本的手术方式。1994由美国Drs.Burbakn,Parker及Fogaty研制Mammotome并应用于临...