Seda ÖZBEK, Ali Sami KIVRAK, ALAADDİN NAYMAN, Hasan ERDOĞAN, Mahmut ÇELİK, Mustafa KOPLAY

Mikrokalsifikasyonların tanısında vakum destekli stereotaktik meme biyopsisi: Üç yıllık deneyimlerimiz

Amaç: Vakum destekli stereotaktik meme biyopsisi (VDSB), günümüzde giderek artan sıklıkla kullanılan, gereksiz eksizyonel biyopsileri önleyebilecek, basit, güvenli, minimal invaziv bir perkütan biyopsi yöntemidir. Bu geriye dönük çalışmanın amacı, mikrokalsifikasyonların tanısında kullandığımız VDSB ile ilgili deneyimlerimizi sunmaktır. Gereç ve Yöntem: Selçuk Üniversitesi Tıp Fakültesi Hastanesi'nde, 2010-2013 yılları arasında mamografisinde mikrokalsifikasyon saptanmış ve VDSB uygulanmış 46 olgunun dosya bilgileri geriye dönük olarak incelenmiştir. Mikrokalsifikasyonların özellikleri, VDSB uygulamaları sırasında ve sonrasında karşılaşılan erken ve geç dönem komplikasyonlar, histopatolojik sonuçlar, takip sonuçları değerlendirilmiş ve sonuçlar hasta sayısı, yüzde ve ortalama ± standart sapma olarak sunulmuştur. Bulgular: VDSB yapılan 46 olguya ait mamogramlarda en çok küme oluşturan pleomorfik (%32,6) mikrokalsifikasyonlar görülmüştür.VDSB'ye bağlı erken dönem komplikasyonlar %15,2 olguda ağrı, %2,2 olguda hematom, % 2,2 olguda ise ekimozdur. Olguların hiç birisinde geç dönemde komplikasyon ile karşılaşılmamıştır. 29 olguda (% 63) histopatoloji benign, 17 olguda (%37.0) ise malign olarak sonuçlanmıştır. 11(%23,9) olguda saptanan duktal karsinoma insitu, bir olguda (%2,2) saptanan lobüler karsinoma insitu, dört (%8,7) olguda saptanan atipik duktal hiperplazi göz önüne alındığında, toplam 16 olguda (%34,7) tümör henüz prekürsor iken veya hücre içi aşamada yakalanmıştır. Sonuç: VDSB, özellikle mamografik mikrokalsifikasyonların tanısında cerrahi biyopsilere göre öncelikle tercih edilebilecek minimal invaziv bir yöntemdir. Benign olgularda hasta için anksiyete ve morbidite kaynağı olabilecek gereksiz cerrahi girişimleri önlemekte malign olgularda ise klinisyene tedavi planında yol gösterici olmaktadır.

Our three years experience in the diagnosis of microcalcifications with vacuum-assisted stereotactic breast biopsy

Objectives: Vacuum-assisted stereotactic breast biopsy (VASB) is an easy, safe and minimal invasive percutaneous biopsy technique which is helpful to avoid unnecessary excisional biopsies. The aim of this study is to present our experiences with VASB in the diag- nosis of microcalcifications. Material and methods: The files of 46 patients who underwent VASB between the years 2010 to 2013 at hospital of Selcuk University Medical Faculty were retrospectively evaluated. The radiological characteristics of microcalcifications, early and late complications encountered during and after VASB applications, histopathologic results, follow-up results were analysed. Results are given as number of patients, percentage and mean ± standard deviation. Results: The clustered pleomorphic microcal- cifications (32.6%) were the the most frequent microcalcification pattern at the mammograms of the 46 patients. Immediate comp- lications encountered as pain in 15.2% patients , hematoma in 2.2% patients and ecchymosis in 2.2% patients. No late complication occurred in the follow-ups. Histopathology revealed 29 (63%) benign and 17 (37%) malignant lesions. Ductal carcinoma in situ was identified in 11 patients (23.9 %), lobular carcinoma in sutu was found in one (2.2%) patient. Atypical ductal hyperplasia was detected in four (8.7%) patients. Accordingly, in a total of 16 (34.7%) cases, the tumor was captured while precursor lesion or in intracellular stage. Conclusions: VASB is a minimally invasive percutaneous, breast biopsy technique which is preferred to surgical methods in evaluation of macrocalcifications in mammography . It is important not also in avoiding unnecessary surgical interventions that may cause anxiety and morbidity in patients with benign lesions but also in guiding clinicians for planning the treatment of malignancies.

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