乳腺原位癌伴微小浸润的临床及病理学分析.pdfVIP

中华普通外科杂志2007年12月第22卷第12期 Chin J Gen Surg，December 2007。V01．22，No．12 ． 论著 ． 乳腺原位癌伴微小浸润的 临床及病理学分析 刘淼 陈定宝 杨德启 乔新民 张嘉庆 【摘要】 目的 总结和分析乳腺导管原位癌伴微小浸润(T．mic)的l临床和组织病理特征，探讨 合理的治疗方法。 方法 总结自1996年1月至2006年6月底共31名患者32例乳腺导管原位癌伴 微小浸润的l临床特征，组织病理特征，治疗方法及随访资料。 结果 经病理诊断的32例乳腺导管原 位癌伴微小浸润患者中，最大浸润灶均≤1 mln，其中有27例(84％)l临床上可触及肿块，有30例 (93．8％)钼靶上有异常表现，病理可见粉刺样结构的病例为19例(59．4％)，可见坏死的为加 例 (62．5％)。25例行腋窝淋巴结清扫术的患者没有一例有腋窝淋巴结转移。经过中位时间为28个月 的随访无一例发生复发和转移。 结论 乳腺导管原位癌伴微小浸润是一个少见的乳腺癌亚型，其预 后很好。治疗上应该根据其原位癌成分的病理特点及l临床特征进行治疗。 【关键词】乳腺肿瘤；癌，原位；微小浸润 Bfeast啪 cer in situ with microinvasion L／U Miao，cJ晒lⅣDing．boo， J7vG De．qi，0IA0 n．rain． zHANG Jia-qing．Center ofBreast Diseases，Peking University Peoplet S Hospital，Be g 100044，China Corresponding author：LIU Miao，E．mail：liumiao@CSCO．org．cn 【Abstract】 0bjective To analyze the clinical and pathological features of breast cancer in situ wi山microinvasion(T．mic)and to seek for rationale managements． Methods Thirty．two breast cancer foci in 31 patients from January 1996 to June 20o6 were diagnosed as T．mic．We made an analysis on the clinical and pathological features，treatments and prognosis． Results The 32 T，mic breast cancer tissues were all with invasive foci≤1 mm．Among山em，27 cases(84％)had palpable masses，30(93．75％) presented mammographically-detected lesions，19(59．4％)had comedo patterns and 20(62．5％) demonstrated necrosis．No lymph node metastasis Was found in the 25 patients wi山 axiilary lymph node dissection．No patients had local recurrence and distant metastasis after a median foilOW—uD of 38 months． Conclusion T．mic iS a less common type of breast carcinoma with extremely good prognosis．We should treat it according to its pathologic features of the accompanying carcinoma in situ and its clinical profiles． 【KeY words l Breast neoplasms： Carcinoma in situ： Microinvasion 原位癌伴微小浸润的概念最早出现是在