• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1715-1718
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• 2015

Background: Magnetic resonance imaging of breast, reported to be a high sensitivity of 94% to 100%, is the most sensitive method for detection of breast cancer. The purpose of this study was to investigate our clinical experience in MRI-guided breast lesion wire localization in Chinese women. Materials and Methods: A total of 44 patients with 46 lesions undergoing MRI-guided breast lesion localization were prospectively entered into this study between November 2013 and September 2014. Samples were collected using a 1.5-T magnet with a special MR biopsy positioning frame device. We evaluated clinical lesion characteristics on pre-biopsy MRI, pathologic results, and dynamic curve type baseline analysis. Results: Of the total of 46 wire localization excision biopsied lesions carried out in 44 female patients, pathology revealed fourteen malignancies (14/46, 30.4%) and thirty-two benign lesions (32/46, 69.6%). All lesions were successfully localized followed by excision biopsy and assessed for morphologic features highly suggestive of malignancy according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category of MRI (C4a=18, C4b=17, C4c=8,C5=3). Of 46 lesions, 37 were masses and 9 were non-mass enhancement lesions. Thirty-two lesions showed a continuous kinetics curve, 11 were plateau and 3 were washout. Conclusions: Our study showed success in MRI-guided breast lesion wire localization with a satisfactory cancer diagnosis rate of 30.4%. MRI-guided wire localization breast lesion open biopsy is a safe and effective tool for the workup of suspicious lesions seen on breast MRI alone without major complications. This may contribute to increasing the diagnosis rate of early breast cancer and improve the prognosis in Chinese women.

• 대한영상의학회지
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• 제84권2호
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• pp.320-331
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• 2023

유방촬영술을 이용한 유방암 검진은 표준 영상 방법이다. 초음파에서 보이지 않고 유방촬영술이나 디지털 유방 토모신테시스에서만 보이는 의심스러운 석회화, 구조 왜곡의 조직학적 진단을 위해 입체정위생검과 유방촬영술 유도하 수술 전 위치결정술을 시행한다. 본 종설에서는 입체정위생검의 적응증 및 비적응증, 방법, 입체정위생검 후 클립 삽입과 디지털 유방 토모신테시스 유도하 입체정위생검에 대해 알아보고자 한다. 또한, 유방촬영술 유도하 수술 전 위치결정술을 침위치결정술과 비침위치결정술로 나누어 소개하고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.4989-4992
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• 2012

Purpose: Guide-wire localization (GWL) has been a standard technique for many years. Excision of nonpalpable malignant breast lesions with clear surgical margins reduces the risk of undergoing re-excision. The objective of the present study was to evaluate the efficacy of GWL biopsy for assessing surgical margins. Methods: This retrospective study concerned 53 patients who underwent GWL biopsy for non-palpable breast lesions and breast carcinoma diagnosed by histological examination. Age of the patients, tumour size, radiographic findings, breast density specifications, specimen volumes, menopausal status and family history of the patients and surgical margin status were recorded. Results: Median age was 53.3 years, median tumour size was 1.5 cm and median specimen volume was $71.5cm^3$. In fifteen patients (28%) DCIS and in 38 patients (72%) invasive ductal carcinoma was diagnosed. There was positive surgical margins in twenty eight (52.8%) patients. The median distance to the nearest surgical margin was 7.2 mm in clear surgical margins. Younger age and denser breast specifications were found as statistically significant factors for surgical margin status. Median age of the patients who had positive margins was 49.4 years where it was 56.9 years in the patients with negative margins (p=0.04). 79% of the patients with positive margins had type 3-4 pattern breast density according to BIRADS classification as compared to 48% in the patients who had negative margins (p=0.03). Some 38 patients who had positive or close surgical margins received re-excision (72%). Conclusion: Positive margin rates may be higher because of inherent biological differences and diffuse growth patterns in younger patients. There are also technical difficulties that are relevant to denser fibroglandular tissue in placing hooked wire. High re-excision rates must be taken into consideration while performing GWL biopsy in non-palpable breast lesions.

• Clinical Endoscopy
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• 제56권4호
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• pp.527-530
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• 2023

• Journal of Chest Surgery
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• 제43권6호
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• pp.681-686
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• 2010

배경: 흉부전산화단층촬영이 보편화되면서 기존의 단순흉부촬영에서는 발견되지 않았던 작은 폐결절이 발견되는 경우가 많아졌다. 이렇게 발견된 폐결절중 크기가 작거나 폐실질 내부에 위치한 결절은 육안 및 촉진으로 확인이 어려운 경우가 많아 생검을 시행하는데 어려움이 따른다. 본원에서는 흉부 전산화단층촬영 유도하에 Hook wire를 사용하여 위치선정을 시행한 후 흉강경하 폐쐐기절제술을 시행하였다. 대상 및 방법: 2006년 12월부터 2010년 6월까지 31명의 환자(남자 17명, 여자 14명)에서 34개의 폐결절을 대상으로 흉부전산화단층촬영 유도 하에 Hook wire를 사용하여 위치선정을 한 후, 흉강경하 폐쐐기절제술을 시행하였다. Hook wire의 이탈 여부, 개흉술 전환 빈도, 위치선정 후 수술 시작까지의 시간, 수술시간, 수술 후 합병증, 대상 병변의 조직학적 진단 등을 분석하였다. 결과: 34예 중 12예는 간유리 병변이었으며 22예는 고형의 폐결절이었다. 병변 크기의 중앙값은 8 mm (범위: 3~23 mm)였으며 병변 깊이의 중앙값은 12.5 mm (범위 1~34 mm)였다. 위치선정 후 마취 시작까지 걸린 시간의 중앙값은 86.5분(41~473분)이었으며, 수술시간의 중앙값은 103분(25~345분)이었다. 1예에서 wire의 흉강 내 이탈이 있었으나 성공적으로 목표 병변을 절제하였다. 4예에서 흉막유착으로 인해 개흉술을 시행하였다. 그러나 목표 병변을 찾지 못해 개흉술로 전환한 예는 없었다. 조직학적 진단에서 전이성 암이 15예로 가장 많았으며, 원발생 폐암 9예, 비특이적 염증소견 3예, 결핵성 염증소견 2예. 림프절 2예, 활동성 결핵 l예, 비정형 샘 증식증 1예 및 정상폐조직 1예로 보고되었다. 결론: 폐실질 내에 위치한 간유리 음영 및 폐결절의 정확한 조직학적 진단을 위해 본원에서는 흉부전산화단층촬영 유도하 Hook wire를 삽입하여 폐결절의 위치를 선정한 후 폐 생검을 시행하였다. 저자들은 이 방법이 정확하면서 최소침습적이고 합병증 발생 및 진료비 상승을 최소화할 수 있는 유용한 술기라고 생각한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3185-3190
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• 2016

Background: This study was designed to compare radioguided versus routine wire localization of nonpalpable non-malignant breast lesions in terms of efficacy for complete excision, ease of use, time saving, and cosmetic outcome. Materials and Methods: Patients with non-palpable breast masses and non-malignant core biopsy results who were candidates for complete surgical lumpectomy were enrolled and randomly assigned to radioguided or wire localization groups. Radiologic, surgical, and pathologic data were collected and analyzed to determine the difficulty and duration of each procedure, ease of use, accuracy, and cosmetic outcomes. Results: This prospective randomized study included 60 patients, randomly divided into wire guided localization (WGL) or radioguided occult lesion localization (ROLL) groups. The mean duration of localization under ultrasound guidance was shorter in the ROLL group (14.4 min) than in the WGL group (16.5 min) (p<0.001). The ROLL method was significantly easier for radiologists (p=0.0001). The mean duration of the surgical procedure was 22.6 min (${\pm}10.3min$) for ROLL and 23.6 min (${\pm}9.6min$) for WGL (p=0.6), a non-significant difference. Radiography of the surgical specimens showed 100% lesion excision with clear margins, as proved by pathologic examination, with both techniques. The surgical specimens were slightly heavier in the ROLL group, but the difference was not significant (p=0.06). Conclusions: The ROLL technique provides effective, fast, and simple localization and excision of non-palpable non-malignant breast lesions.