Abstract: Objective To evaluate the value of ultrasound-guided vacuum assisted resection （UGVAE） in the diagnosis and treatment of breast intraductal papilloma. Methods From February 2018 to February 2021, our department used UGVAE to diagnose 89 patients with intraductal papilloma of the breast. We retrospectively analyzed 33 patients who had regular postoperative breast imaging follow-up, 8 patients were diagnosed as bilateral intraductal papilloma of the breast. The follow-up period ranged from 14 to 50 months, with an average of 25.7 months. All intraductal papillomas of the breast were far away from the skin. The diameter of the lesion was 2.4~20 mm, with an average of 9 mm. The breast image report and data system （BIRADS） were diagnosed as category 2-4a. Vacuum-assisted excision was used for complete resection. All VAEs were performed with 8G vacuum assisted biopsy needle under the guidance of 12 mHz linear high frequency probe. Results In this study, the diameter of papilloma was less than 20 mm, and most of the patients with breast papilloma were asymptomatic （19/33, 57.6%）. When the diameterof breast papilloma on ultrasound was more than 10 mm, the pathological diagnosis after biopsy might be papilloma with atypical hyperplasia. The recurrence rate of papilloma after VAE is very low even without extensive resection. Conclusion Papilloma of breast with diameter less than 20 mm, including papilloma with atypical hyperplasia, which can be completely removed by VAE, with accurate diagnosis and low recurrence rate. We believe that the papilloma diagnosed by VAE does not need extensive resection, and imaging follow-up is sufficient.

Key words: papilloma, breast, VAE, treatment

摘要： 目的 目前临床上对乳腺导管内乳头状瘤的处理仍存在争议。因此,本文旨在评估超声引导下真空辅助切除手术（UGVAE）在乳腺导管内乳头状瘤的诊断和治疗价值。方法 选取2018年2月至2021年2月期间使用UGVAE诊断的89例乳腺导管内乳头状瘤患者,回顾性分析定期进行术后乳腺影像学随访的33例患者,其中8例患者被诊断为双侧乳腺导管内乳头状瘤。随访时间为14~50个月,平均25.7个月。所有的乳腺导管内乳头状瘤均远离皮肤,病灶直径为2.4~20 mm,平均9 mm,乳腺影像评估系统（BI-RADS）诊断为BI-RADS 2~4a级别,使用真空辅助切除手术（VAE）完全切除。所有的真空辅助切除手术均在12 mHz线性高频探头超声引导下,使用8G真空辅助活检针完成。结果 本研究随访的乳头状瘤直径均<20 mm,且大多数乳腺乳头状瘤患者无症状（19/33,57.6%）,当超声图像上乳腺乳头状病变的大小超过10 mm时,活检后病理诊断可能为乳头状瘤伴有不典型增生。VAE术后乳头状瘤即使未进行扩大切除,复发率也很低。结论 对于直径小于20 mm的乳腺导管内乳头状瘤,包括存在不典型增生的乳头状瘤,真空辅助切除手术可以完全切除,诊断准确,复发率低。经真空辅助切除手术诊断的乳头状瘤不需要进行扩大切除,影像学随访即可。

关键词: 乳头状瘤, 乳腺, 真空辅助切除手术, 治疗