Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S0100-72032004000100006 http://repositorio.unifesp.br/handle/11600/1979 |
Resumo: | PURPOSE: to evaluate the accuracy of directional vacuum-assisted biopsy (mammotomy), guided by ultrasonography, in the diagnosis of nonpalpable breast lesion, as compared with excision biopsy, and to evaluate the therapeutic value of mammotomy in nonpalpable benign lesions. METHODS: 114 patients, who presented nonpalpable breast lesion, visible on ultrasonography, were included. The patients were referred to complementary ultrasonographic evaluation due to mastalgia or earlier found mammographic alteration. All were submitted to mammotomy guided by ultrasonography using Mammotome® (Biopsys, Irvine, Califórnia), with a 11 gauge needle. The excision biopsy was performed with previous puncture of those patients who presented residual lesion after the mammotomy, that is, 88 patients. To evaluate comparatively the mammotomy results with those of excision biopsy, the sensitivity and specificity rates, positive and negative predictive values, and the agreement proportion were calculated. Not only the sensibilities, but also the specificities and the agreement proportions of both examinations were compared through Wald statistics, using a model for classified data. RESULTS: of 114 patients, 88 were submitted to excision biopsy. The remaining 26 did not show post-mammotomy lesions visible on ultrasonography, and for one year they were without alterations on the bi-annual mammographic and ultrasonographic examinations. The diameter of those lesions was less than 1.5 cm. Among the 88 patients that underwent excision biopsy, 69 (78,4%) showed benign and 19 (21,6%), malignant lesions. Mammotomy diagnosed 16 of the malignant lesions, with three false-negative and no false-positive results. The false results occurred in the first cases, showing the existence of a learning curve of the method, or due to technical difficulty such as the blurring of ultrasonographic image by bleeding. The sensitivity and specificity were 84,2% and 100%, respectively, with 100% positive predictive and 95,8% predictive negative values. The mammotomy accuracy was 96,6%. Complications were rare: two cases of hematomas, none of them needing surgical drainage; a case of vasovagal reflex not allowing the conclusion of the examination. The cosmetic results were very favorable due to small incisions (3 mm) and to the smaller amount of excised tissue. CONCLUSION: mammotomy guided by ultrasonography showed to be a diagnostic method with high accuracy, and it may be used as therapy for benign, smaller than 1.5 cm lesions. |
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Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveisUsefulness of mammoty in diagnosis and therapy of nonpalpable lesionsMammotomyNonpalpable breast lesionsBreast cancerMamotomiaLesões não palpáveis da mamaMamaPURPOSE: to evaluate the accuracy of directional vacuum-assisted biopsy (mammotomy), guided by ultrasonography, in the diagnosis of nonpalpable breast lesion, as compared with excision biopsy, and to evaluate the therapeutic value of mammotomy in nonpalpable benign lesions. METHODS: 114 patients, who presented nonpalpable breast lesion, visible on ultrasonography, were included. The patients were referred to complementary ultrasonographic evaluation due to mastalgia or earlier found mammographic alteration. All were submitted to mammotomy guided by ultrasonography using Mammotome® (Biopsys, Irvine, Califórnia), with a 11 gauge needle. The excision biopsy was performed with previous puncture of those patients who presented residual lesion after the mammotomy, that is, 88 patients. To evaluate comparatively the mammotomy results with those of excision biopsy, the sensitivity and specificity rates, positive and negative predictive values, and the agreement proportion were calculated. Not only the sensibilities, but also the specificities and the agreement proportions of both examinations were compared through Wald statistics, using a model for classified data. RESULTS: of 114 patients, 88 were submitted to excision biopsy. The remaining 26 did not show post-mammotomy lesions visible on ultrasonography, and for one year they were without alterations on the bi-annual mammographic and ultrasonographic examinations. The diameter of those lesions was less than 1.5 cm. Among the 88 patients that underwent excision biopsy, 69 (78,4%) showed benign and 19 (21,6%), malignant lesions. Mammotomy diagnosed 16 of the malignant lesions, with three false-negative and no false-positive results. The false results occurred in the first cases, showing the existence of a learning curve of the method, or due to technical difficulty such as the blurring of ultrasonographic image by bleeding. The sensitivity and specificity were 84,2% and 100%, respectively, with 100% positive predictive and 95,8% predictive negative values. The mammotomy accuracy was 96,6%. Complications were rare: two cases of hematomas, none of them needing surgical drainage; a case of vasovagal reflex not allowing the conclusion of the examination. The cosmetic results were very favorable due to small incisions (3 mm) and to the smaller amount of excised tissue. CONCLUSION: mammotomy guided by ultrasonography showed to be a diagnostic method with high accuracy, and it may be used as therapy for benign, smaller than 1.5 cm lesions.OBJETIVOS: avaliar a acurácia diagnóstica da biópsia direcional assistida à vácuo (mamotomia), guiada por ultra-sonografia, no diagnóstico das lesões mamárias não palpáveis, comparando-a com a biópsia excisional, e estimar o valor terapêutico da mamotomia em lesões benignas não palpáveis. MÉTODOS: foram incluídas 114 pacientes, as quais apresentavam lesões mamárias não palpáveis, visíveis à ultra-sonografia. As pacientes foram encaminhadas devido mastalgia ou alteração mamográfica detectada previamente, com solicitação de avaliação ultra-sonográfica complementar. Todas foram submetidas à mamotomia guiada por ultra-sonografia com Mammotome® (Biopsys, Irvine, Califórnia), com sonda gauge 11. A biópsia excisional foi realizada com agulhamento prévio daquelas pacientes que apresentaram lesão residual após a mamotomia, ou seja, em 88 pacientes. Para comparar os resultados do material obtido por mamotomia com os da biópsia excisional foram calculados os índices de sensibilidade e especificidade, valores preditivos positivo e negativo, e a proporção de concordância. As sensibilidades, assim como as especificidades e as proporções de concordância dos dois exames, foram comparadas por meio da estatística de Wald, utilizando um modelo para dados categorizados. RESULTADOS: das 114 pacientes, 88 submeteram-se a biópsia excisional. As 26 restantes não apresentaram lesões pós-mamotomia, visíveis à ultra-sonografia, sendo seguidas por um ano sem alterações nos exames semestrais, tanto mamográficos quanto ultra-sonográficos. Tratava-se de lesões menores do que 1,5 cm de diâmetro. Dentre as 88 pacientes submetidas à biópsia excisional 69 apresentaram lesões benignas (78,4%) e, 19 (21,6%), malignas. A mamotomia diagnosticou 16 das lesões malignas, com três resultados falso-negativos e nenhum falso-positivo. Os resultados falsos ocorreram: nos primeiros casos realizados, mostrando a existência de curva de aprendizagem do método ou por dificuldade técnica, como o borramento da imagem ultra-sonográfica por sangramento. A sensibilidade e especificidade foram de 84,2 e 100%, respectivamente, com valores preditivos positivo de 100%, e negativo de 95,8%. A acurácia da mamotomia foi de 96,6%. As complicações foram raras, como, dois casos de hematomas, dos quais nenhum necessitou de drenagem cirúrgica; um caso de reflexo vaso-vagal, impedindo a conclusão do exame. Os resultados cosméticos foram bastante favoráveis devido às pequenas incisões (3 mm) e menor quantidade de tecido excisado. CONCLUSÃO: a mamotomia guiada por ultra-sonografia mostrou-se método diagnóstico com alta acurácia, podendo ser usado como terapêutico para as lesões benignas, com diâmetro menor do que 1,5 cm.Escola Paulista de Medicina Setor de Mastologia da Disciplina de GinecologiaUNIFESP, EPM, Setor de Mastologia da Disciplina de GinecologiaSciELOFederação Brasileira das Sociedades de Ginecologia e ObstetríciaUniversidade Federal de São Paulo (UNIFESP)Ambrosio, Aline Cristina Camacho [UNIFESP]Kemp, Claudio [UNIFESP]Gonçalves, Thiers Deda [UNIFESP]Lima, Geraldo Rodrigues De [UNIFESP]2015-06-14T13:30:16Z2015-06-14T13:30:16Z2004-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion37-42application/pdfhttp://dx.doi.org/10.1590/S0100-72032004000100006Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 26, n. 1, p. 37-42, 2004.10.1590/S0100-72032004000100006S0100-72032004000100006.pdf0100-7203S0100-72032004000100006http://repositorio.unifesp.br/handle/11600/1979porRevista Brasileira de Ginecologia e Obstetríciainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-28T06:32:59Zoai:repositorio.unifesp.br/:11600/1979Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-28T06:32:59Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis Usefulness of mammoty in diagnosis and therapy of nonpalpable lesions |
title |
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis |
spellingShingle |
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis Ambrosio, Aline Cristina Camacho [UNIFESP] Mammotomy Nonpalpable breast lesions Breast cancer Mamotomia Lesões não palpáveis da mama Mama |
title_short |
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis |
title_full |
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis |
title_fullStr |
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis |
title_full_unstemmed |
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis |
title_sort |
Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis |
author |
Ambrosio, Aline Cristina Camacho [UNIFESP] |
author_facet |
Ambrosio, Aline Cristina Camacho [UNIFESP] Kemp, Claudio [UNIFESP] Gonçalves, Thiers Deda [UNIFESP] Lima, Geraldo Rodrigues De [UNIFESP] |
author_role |
author |
author2 |
Kemp, Claudio [UNIFESP] Gonçalves, Thiers Deda [UNIFESP] Lima, Geraldo Rodrigues De [UNIFESP] |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Ambrosio, Aline Cristina Camacho [UNIFESP] Kemp, Claudio [UNIFESP] Gonçalves, Thiers Deda [UNIFESP] Lima, Geraldo Rodrigues De [UNIFESP] |
dc.subject.por.fl_str_mv |
Mammotomy Nonpalpable breast lesions Breast cancer Mamotomia Lesões não palpáveis da mama Mama |
topic |
Mammotomy Nonpalpable breast lesions Breast cancer Mamotomia Lesões não palpáveis da mama Mama |
description |
PURPOSE: to evaluate the accuracy of directional vacuum-assisted biopsy (mammotomy), guided by ultrasonography, in the diagnosis of nonpalpable breast lesion, as compared with excision biopsy, and to evaluate the therapeutic value of mammotomy in nonpalpable benign lesions. METHODS: 114 patients, who presented nonpalpable breast lesion, visible on ultrasonography, were included. The patients were referred to complementary ultrasonographic evaluation due to mastalgia or earlier found mammographic alteration. All were submitted to mammotomy guided by ultrasonography using Mammotome® (Biopsys, Irvine, Califórnia), with a 11 gauge needle. The excision biopsy was performed with previous puncture of those patients who presented residual lesion after the mammotomy, that is, 88 patients. To evaluate comparatively the mammotomy results with those of excision biopsy, the sensitivity and specificity rates, positive and negative predictive values, and the agreement proportion were calculated. Not only the sensibilities, but also the specificities and the agreement proportions of both examinations were compared through Wald statistics, using a model for classified data. RESULTS: of 114 patients, 88 were submitted to excision biopsy. The remaining 26 did not show post-mammotomy lesions visible on ultrasonography, and for one year they were without alterations on the bi-annual mammographic and ultrasonographic examinations. The diameter of those lesions was less than 1.5 cm. Among the 88 patients that underwent excision biopsy, 69 (78,4%) showed benign and 19 (21,6%), malignant lesions. Mammotomy diagnosed 16 of the malignant lesions, with three false-negative and no false-positive results. The false results occurred in the first cases, showing the existence of a learning curve of the method, or due to technical difficulty such as the blurring of ultrasonographic image by bleeding. The sensitivity and specificity were 84,2% and 100%, respectively, with 100% positive predictive and 95,8% predictive negative values. The mammotomy accuracy was 96,6%. Complications were rare: two cases of hematomas, none of them needing surgical drainage; a case of vasovagal reflex not allowing the conclusion of the examination. The cosmetic results were very favorable due to small incisions (3 mm) and to the smaller amount of excised tissue. CONCLUSION: mammotomy guided by ultrasonography showed to be a diagnostic method with high accuracy, and it may be used as therapy for benign, smaller than 1.5 cm lesions. |
publishDate |
2004 |
dc.date.none.fl_str_mv |
2004-02-01 2015-06-14T13:30:16Z 2015-06-14T13:30:16Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0100-72032004000100006 Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 26, n. 1, p. 37-42, 2004. 10.1590/S0100-72032004000100006 S0100-72032004000100006.pdf 0100-7203 S0100-72032004000100006 http://repositorio.unifesp.br/handle/11600/1979 |
url |
http://dx.doi.org/10.1590/S0100-72032004000100006 http://repositorio.unifesp.br/handle/11600/1979 |
identifier_str_mv |
Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 26, n. 1, p. 37-42, 2004. 10.1590/S0100-72032004000100006 S0100-72032004000100006.pdf 0100-7203 S0100-72032004000100006 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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Revista Brasileira de Ginecologia e Obstetrícia |
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info:eu-repo/semantics/openAccess |
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openAccess |
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37-42 application/pdf |
dc.publisher.none.fl_str_mv |
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
publisher.none.fl_str_mv |
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
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reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
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Universidade Federal de São Paulo (UNIFESP) |
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UNIFESP |
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UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
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biblioteca.csp@unifesp.br |
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1814268337674256384 |