Clinical Application Of Ultrasound Localization Combined With Methylene Blue Staining In The Resection Of Non-palpable Breast Calcification Lesions

BackgroundWith the improvement of people’s health awareness and imaging technology,more and more breast cancer patients can be detected early.Early breast cancer usually presents as asymptomatic and untouchable lesions.Because the early breast lesions are asymptomatic and inaccessible in clinic,they can only be detected by imaging,which increases the difficulty of clinicians’operation.For this kind of breast cancer patients with small lesions,how to accurately locate the lesions and perform pathological biopsy as early as possible is of great significance for the diagnosis,treatment and prognosis of patients.ObjectiveAt present,mammography guided wire localization（MWL）is the most widely used preoperative localization of non-palpable breast calcification lesions（NPBCL）.However,MWL still has many deficiencies in the localization and resection of NPBCL.With the progress of high-frequency ultrasound probe technology,the accuracy of diagnosis of calcification in breast has been greatly improved,which makes it feasible to locate NPBCL under the guidance of color Doppler ultrasound.Therefore,we explore a new location method.This study compared the clinical value of ultrasound-guided methylene blue localization（USMBL）and MWL in NPBCL biopsy.MethodsA total of 77 female patients with suspected calcification in the breast were selected from the Department of Breast and Thyroid Surgery of Nanyang Central Hospital from November 2019 to March 2021.All enrolled patients had no clear lesions on breast palpation,but ultrasound and mammography both suggested suspicious calcification.According to the localization method,47 cases were divided into the USMBL group and 30 cases were MWL group.Surgical resection volume,success rate of complete one-time resection,pathological results of lesions,resection time,incidence of surgical complications and satisfaction rate of postoperative were compared between the two groups.Results1.The success rate of one-time complete resection in the USMBL group was 97.88%（46/47）significantly higher than that of 83.33%（25/30）（P<0.05）in the MWL group.2.In terms of the volume of resected lesions,the total excision volume of the USMBL group was（22.81±14.32）cm~3,and the calculated excision rate of 1.17±0.35 was less than the total excision volume（31.23±15.73）cm~3and the calculated excision rate of 1.58±0.42（P<0.05）in the MWL group.3.The resection time of lesions in the USMBL group was（12.23±3.02）min shorter than that in the MWL group（15.93±4.68）min（P<0.05）.4.The incidence of surgical complications in the USMBL group was 6.38%lower than that in the MWL group（P<0.05）.5.Postoperative satisfaction in the USMBL group was 95.74%higher than that in the MWL group（P<0.05）.ConclusionBoth USMBL and MWL methods completely remove the lesion.USMBL is more accurate for NPBCL localization,high one-time resection rate,short surgical resection time,low incidence of surgical complications,less removal of normal breast tissue,and high postoperative breast shape modification.At the same time,compared with the expensive guide wire positioning method,the price of methylene blue positioning is lower,which can reduce the cost of hospitalization of patients and is worthy of wide clinical promotion.