細針抽吸活檢通常被用于診斷男性乳腺病變，粗針穿刺活檢對于診斷男性乳腺病變的效果尚不明確。

　　2019年6月5日，施普林格·自然《乳腺癌研究與治療》在線發(fā)表復旦大學附屬腫瘤醫(yī)院楊銀龍、李士平、柳光宇、邵志敏等學者的研究報告，探討了超聲引導粗針穿刺活檢能否準確診斷男性乳腺病變。

　　該單中心回顧研究對2007年1月1日～2017年1月1日復旦大學附屬腫瘤醫(yī)院連續(xù)234例男性乳腺病變超聲引導14G粗針穿刺活檢結(jié)果進行分析，并與手術(shù)切除活檢結(jié)果或長期影像隨訪結(jié)果進行比較。

　　結(jié)果，超聲引導14G粗針穿刺活檢有效收集所有234例病變理想標本，其中：

• 良性：137例（58.55%）

• 惡性：89例（38.0%）

• 非典型乳頭狀瘤：4例（1.71%）

• 非典型導管增生：4例（1.71%）

• 低估：8例（3.4%）

　　超聲引導14G粗針穿刺活檢對于乳腺惡性腫瘤的檢出：

• 敏感性：98.9%

• 特異性：100%

• 陰性預測值：99.3%

• 陽性預測值：100%

• 假陽性：0%

• 假陰性：1.1%

　　超聲引導14G粗針穿刺活檢診斷男性乳腺病變的總準確率為99.6%。

　　因此，該研究結(jié)果表明，對于診斷男性乳腺病變，超聲引導14G粗針穿刺活檢準確、可靠、創(chuàng)傷性低。臨床、影像、病理三聯(lián)檢查以及隨訪，對于男性乳腺活檢良性病例至關(guān)重要。

Breast Cancer Res Treat. 2019 Jun 5.

Is core needle biopsy effective at diagnosing male breast lesions?

Yinlong Yang, Shiping Li, Guangyu Liu, Zhiming Shao.

Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China; Shanghai Medical College, Fudan University, Shanghai, China.

PURPOSE: The objective of this study was to examine the diagnostic accuracy of sonographically guided core needle biopsy (CNB) of breast lesions in men.

METHODS: This was a retrospective study where we analyzed consecutive sonographically guided 14-gauge CNB results on 234 male breast lesions. The CNB accuracy is determined by the comparison between the CNB and its corresponding excisional biopsy or to long-term follow-up imaging.

RESULTS: Sonographically guided CNB was effective to collect satisfactory samples from all 234 lesions. Out of those, 58.55% (137/234) were benign, 38.0% (89/234) were malignant, 1.71% (4/234) were papilloma with atypia and 1.71% (4/234) were atypical ductal hyperplasia lesions. Underestimation occurred in 3.4% (8/234) of the lesions. As for the detection of breast malignancy, the sensitivity of the CNB is 98.9%, specificity is 100%, negative predictive value is 99.3%, positive predictive value is 100%, false positive is 0% and false negative is 1.1%. The overall accuracy of sonographically guided CNB as a diagnostic tool is 99.6%.

CONCLUSIONS: Sonographically guided 14-gauge CNB is an accurate, reliable and low invasive procedure for assessing breast lesions in men. Triple tests and follow-up checks of benign cases are essential for a successful breast biopsy program in men.

KEYWORDS: Male lesions; Breast neoplasm; Core needle biopsy; Breast ultrasonography; Male breast cancer

DOI: 10.1007/s10549-019-05312-x