In recent years, due to the application of neoadjuvant chemotherapy in the treatment of breast cancer, breast masses not surgical biopsy can
In recent years, due to the application of neoadjuvant chemotherapy in the treatment of breast cancer, breast masses not surgical biopsy can be acquired by fine needle aspiration cytopathology (fine needle aspiration cytopathology, FNAC) evolved into a hollow needle biopsy (core needle biopsy). Hollow needle puncture histopathological examination, with the aid of a hollow needle gun is an instrument, the suspicious breast lesions (mass, thickening area, calcification, etc.) to take out some of the glands of the tissue. Hollow needle biopsy specimens taken out of the shape of the strip, diameter depends on the thickness of the hollow needle diameter, length of 2 cm. This technology uses the special puncture thick needle (international number 14-16, needle outer diameter 2-4mm), our hospital breast surgery uses 14 (outer diameter 2mm).
Hollow needle biopsy of breast
1 preparation before the puncture to the patient details of the purpose of CNB. Routine examination of blood coagulation function to exclude abnormal coagulation system, B ultrasound examination of the cystic lesions of the breast. Automatic biopsy gun, puncture bag, specimen bottle and local anesthetic.
2 operation method according to the tumor location, take appropriate position for supine position. First of all, select the puncture site, needle point, puncture direction, depth, angle, the long axis, note that the needle should be parallel to the body surface, to avoid the needle pointing to the human body and visceral injury. Preoperative routine disinfection of the skin, local anesthesia puncture point skin, sterile blade incision puncture point skin. The puncture gun enters the mass edge from the puncture point, and the mass is fixed. After the success of the puncture, a slight movement of the puncture gun can be observed to determine whether the mass can be taken to confirm the location of the lesion. Each mass can be drawn 4-6, and each should be taken to different parts of the mass, in order to improve the positive rate.
3 after the treatment of puncture after partial pressure bandage to avoid bleeding and hematoma. Oral antibiotics for 3 days to prevent infection.
Two, the advantages of CNB
1 simple operation, small trauma. Can save the pain of open surgery.
2 can provide pathological basis for neoadjuvant chemotherapy patients. CNB not only can be clearly diagnosed, and enough specimens can provide ER, PR, HER2 and other indicators, for chemotherapy, endocrine therapy, targeted therapy to provide a pathological basis.
3 we can take into account the evaluation of the tissue structure and cytological features, which can distinguish the carcinoma in situ and invasive carcinoma, improve the accuracy of diagnosis, and is helpful to the treatment plan.
4.CNB material is more, the negative rate of diagnosis is reduced, and the level of clinical diagnosis is improved.
5 less complications, high safety. The main complications of CNB were hemorrhage and infection, and appropriate methods and measures could significantly reduce the incidence of complications.
Three, CNB clinical application
CNB is a safe, reliable and convenient method for pathological diagnosis, which is to take out the small tissue strips and perform histopathological examination. In Europe and the United States large breast center, CNB has been replaced by FNAC examination, the most commonly used diagnostic means, there is a tendency to replace intraoperative frozen section examination. At present, in our country CBN has been carried out in large hospitals, the main application of qualitative diagnosis of breast lumps. Breast surgery in our hospital has been mature to carry out this technology, the pathology department of the tissue specimens for systematic histopathological and immunohistochemical examination, detailed and timely diagnosis report.