- 期刊
探討立體定位真空輔助乳房切片檢查中標記夾位移原因
Exploring the Factors of Clip Migration in Stereotactic Guided Vacuum Assisted Breast Biopsy
摘要
本研究探討立體定位真空輔助乳房切片術（Stereotactic guided vacuum assisted breast biopsy，VABB）過程中組織標記夾位移的可能潛在因素，透過回顧文獻，整理出14種可能影響位移的因素，包括乳房的厚度和緻密度、病灶距離皮膚表面的深淺度、使用的標記夾類型以及有無形成血腫等。此研究收集2017年4月至2020年10月期間至本院接受該項檢查的360名患者，其中319例被納入最終分析，分別探討位移大於1公分及大於2公分的結果。319例中位移大於1公分有80例（25.07%），位移大於2公分有43例（13.47%），皆與病灶距離皮膚表面的深淺度有關聯性（>1公分p=0.042；>2公分p=0.047），且局部乳腺緻密度越高越不容易導致位移（兩者皆p<0.001）。研究結果發現較靠近皮膚表面的病灶較容易導致位移，而此處的乳腺緻密度也相對較低，更容易導致標記夾無法固定的情況。因此，若有明顯位移者需執行後續治療時，會利用殘餘鈣化進行細針定位，而無殘餘鈣化時，也可考慮使用敏感度較高的磁振造影，找出原先病灶處，再執行細針定位，幫助臨床醫師將原本病灶處的組織切除。
並列摘要
This study explores possible factors for tissue clip migration during stereotactic guided vacuum assisted breast biopsy (VABB). Through a review of the literature, 14 factors that may affect migration were found, including the thickness, breast density, superficial lesion, clip type, and hematoma. This study collected a total of 360 patients who underwent VABB in our hospital from April 2017 to October 2020, 319 of them were included in the final analysis to explore the results of migration >1 cm and >2 cm respectively. Of the 319 cases, 80(25.07%) with migration >1 cm, 43(13.47%) with migration >2 cm. They are all related to more superficial lesions (lesion closer to skin) (>1 cm p = 0.042; >2 cm p = 0.047), and the higher the local breast density, the less likely it is to cause migration (p < 0.001). The results of the study found that more superficial lesions are more likely to cause migration, and their breast density is also lower, making it easier for the clip to be unable to be fixed. Therefore, if such patients need further treatment, residual calcification will be used for positioning, and if there is no residual calcification, magnetic resonance imaging (MRI) will be used to find the original lesion, then use the wire localization to help clinicians remove the tissue at the original lesion.