可手术年轻乳腺癌92例临床分析

目的]探讨可手术年轻乳腺癌的临床病理特点及诊治策略。方法]回顾分析92例年龄≤40岁的可手术乳腺癌患者（年轻组）的临床资料，随机抽取年龄在41—69岁的年长乳腺癌患者（年长组）92例与年轻组作临床病理特点分析比较。结果]年轻组肿块长径0．8～6．5cm，平均2．8era。浸润性导管癌82例，导管内癌、导管内癌微浸润、髓样癌各2例，导管内乳头状瘤原位癌、黏液腺癌、浸润性导管癌伴灶区黏液腺癌、混合性癌各1例。淋巴结分期Nn19例，N1 51例，N2及以上22例。浸润癌组织学分级Ⅰ-Ⅱ级47例，Ⅲ级42例。免疫组化：ER／PR阳性57例，Her-2阳性30例；三阴性乳腺癌22例；有癌栓者33例。病理分期0期3例，Ⅰ期28例，Ⅱ期35例，Ⅲ期26例。与年长组比较，年轻组在高组织学分级、Her-2阳性、伴有癌栓三者比例较高，差异有统计学意义（P值分别为0．048、0．044、0．022）；而在肿瘤大小、是否为浸润性癌、淋巴结分期、激素受体阳性比例、是否三阴性乳腺癌及病理分期上与年长组均无明显差异（P〉0．05）。结论]年轻乳腺癌有独特的病理学特点，恶性程度更高，应早诊断、早治疗。

Clinical Analysis of 92 Young Women with Resectable Breast Cancer

Purposel To explore the clinical and pathologic features of young women with re- sectable breast cancer. Methods] The clinical features of 92 resectable breast cancer patients under 40 years old were retrospectively analyzed, and the date were compared and analyzed with the old women with breast cancer aged from 41 to 69 years old,who were randomly selected at the same period. Results] In the young group,the tumor size is 0.8-6.5cm with the average of 2.Scm.Eighty-two cases occurred invasive ductal carcinoma;2 cases,ductal carcinoma in situ; 2 cases, ductal carcinoma in situ with microinvasion ; 2 cases, medullary carcinoma; 1 case, intraductal papilloma canceration in situ; 1 case,mucinous adenocarcinoma;1 case,invasive ductal carcinoma accompany focal area mucinous adenocarcinoma; 1 case, mixed carcinoma respectively. According to lymph node stage, 19 cases were stage N0;51 cases,stage N1;22 cases, stage N2 or above. According to histological grade of invasive breast carcinoma,47 cases were garde I - U ;42 cases,grade 1I. Positive expression of ER/PR was in 57 cases,and positive expression of Her-2 was in 30 cases. 22 cases were triple negative breast cancer,and 33 cases had cancer embolus. According to pTNM stage,3 cases were stage 0;28 cases,stage I ; 35 cases, stage I1 ;26 cases,stage 11I respectively. Compared With the elder group,there were more patients with higher histological grade（P=0.048）, Her-2 positive（P=-0.044） and with cancer embolus （P=0.022） in the young group. No statistical significance between difference of tumor size,can- cer invasion,lymph node metastasis,the proportion of ER/PR positive,triple negative breast cancer and pTMN stages between the 2 groups （P〉0.05）. Conclusion] The young women with resectable breast cancer have specific pathologic characteristics and more agression of malignancy, and should be diagnosed and treated early.