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目的：探讨乳腺内不可触及病灶(NPBL)的定位活检技术及其在乳腺癌早期诊断中的临床应用价值。方法：对彩超发现的 4459 个和钼靶发现的25 个NPBL 分别行麦默通旋切和钩丝定位活检，确定病灶的病理类型。结果：4459 个NPBL 中3196 个病灶为乳腺腺病或伴纤维腺瘤样结节（71.7%），1198 个为纤维腺瘤（26.9%），11 个为分叶状肿瘤（0.2%），17 个为导管内乳头状瘤（0.4%），9 个为乳腺导管原位癌，5 个为导管原位癌伴微浸润，23 个为浸润性癌（恶性占0.8%）。25 个钼靶发现的NPBL中乳腺腺病13 例（52%），导管原位癌7 例，导管原位癌伴微浸润2 例，浸润性癌3 例（恶性占48%）。结论：超声引导下麦默通和钼靶引导下钩丝定位切除可以对NPBL做出定性诊断，具备创伤小、手术时间短和定位精准等特点，对提高乳腺癌的早期诊断率、降低死亡率具有一定的临床应用价值。

英文摘要:

Objective:To investigate techniques of localization biopsy of nonpalpable breast lesions and clinical application value of early diagnosis of breast cancer.Methods:4459 and 25 nonpalpable breast lesions respectively detected by ultrasonography and mammography were removed by mammotome or wire localization, and then confirm types of pathology.Results:3196 focuses in 4459 nonpalpable breast lesions detected by ultrasonography were adenosis of mammary glands with or without fibroadenoma (71.7%), 1198 focuses were fibroadenoma (26.9%), 11 focuses were phyllodes tumor (0.2%), 17 focuses were intraductal papilloma (0.4%), 9 focuses were ductal carcinoma in situ,5 focuses were ductal carcinoma in situ with microinvasion, 23 focuses were invasive carcinoma ( malignant amount to 0.8%). 13 focuses detected by mammography were adenosis of mammary glands (52%), 7 focuses were ductal carcinoma in situ, 2 focuses were ductal carcinoma in situ with microinvasion, and 3 focuses were invasive carcinoma ( malignant amount to 48%).Conclusion:Mammotome and wire localization biopsy became preferential techniques to pathological diagnosis of nonpalpable breast lesions because of less injury and shorter time interval and precise localization. It can promote early diagnosis of breast cancer and reduce mortality rate, which has better clinical application value.

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