乳腺髓样癌90例临床分析

目的探讨乳腺髓样癌的临床特点、治疗及预后。方法回顾性分析90例乳腺髓样癌的临床资料:肿瘤直径(4.1±2.2)cm,左侧49例,右侧41例,21例有腋淋巴结肿大,其中19例术前误诊为良性肿瘤而行局部切除,术中冰冻切片确诊53例,术前细针穿刺确诊18例。行乳癌根治术(Hal-sted法)49例,改良根治术41例,其中保留胸大肌的改良根治术Ⅰ式(Patey手术)29例,保留胸大小肌的改良根治术Ⅱ式(Auchinc loss手术)12例。21例腋淋巴结肿大者行术前辅助化疗,术后均行化疗。结果确诊典型和不典型髓样癌各45例,其腋淋巴结转移率无区别。均获随访,时间5.8(1.5~11)年,3年、5年生存率分别为95.6%和88.9%。结论乳腺髓样癌预后较好,术前应行细针穿刺细胞学检查和术中冰冻切片检查,手术加辅助化疗是治疗的重要手段。

Clinical Analysis of Medullary Breast Carcinoma (90 Cases Report)

Objective To investigate the clinical manifestation,treatment and prognosis of the medullary breast carcinoma（MBC）.Methods The clinical data of 90 patients with MBC were analyzed retrospectively.The tumor size was（4.1±2.2）cm.The location of the tumor was in left of 49 and in right of 41.The diagnosis was made by local excision of 19,by intraoperative frozen section of 53,and by fine needle aspiration of 18.The patients were cured by Halsted＇s mastectomy in 49 cases,Patey＇s procedure in 29 cases and Auchincloss＇s procedure in 12 cases.Results There was no statistically significance in the axillary lymph node metastasis rates between the typical and untypical MBCs.The 3-and 5-year survival rate was 95.6% and 88.9% respectively.Conclusions The common features of MBC are fairly clear boundary mass with good prognosis.It is important to make a definite diagnosis by needle and freeze biopsy.Operation and adjuvant chemotherapy are the main treatment methods for MBC.