Valor da mamotomia no diagnóstico e na terapia de lesões não palpáveis

Detalhes bibliográficos
Autor(a) principal: Ambrosio, Aline Cristina Camacho [UNIFESP]
Data de Publicação: 2004
Outros Autores: Kemp, Claudio [UNIFESP], Gonçalves, Thiers Deda [UNIFESP], Lima, Geraldo Rodrigues De [UNIFESP]
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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spelling 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
dc.relation.none.fl_str_mv Revista Brasileira de Ginecologia e Obstetrícia
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.format.none.fl_str_mv 37-42
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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
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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