108例年轻女性乳腺癌临床及病理特征分析

目的分析年轻女性乳腺癌的临床及病理特征,以利于指导临床诊治。方法回顾性分析笔者医院2004～2008年收治的108例≤35岁和随机抽取同期收治的100例>35岁的女性乳腺癌的临床及病理资料,所有病例均经手术治疗及病理证实。结果≤35岁年轻组乳腺癌占同期乳腺癌的8.2%,误诊率为39.8%。年轻组在确诊时间≤1个月(32.4%、48.0%)、脉管癌栓(12.0%、3%)、原发肿瘤直径>5cm(21.3%、8%)、腋窝淋巴结转移4～9个(21.3%、10%)、pTNM分期Ⅲ～Ⅳ期(42.6%、29%)、Her-2阳性(41.7%、20%)方面与中老年组的差异具有统计学意义(P<0.05)。两组病理类型、组织学分级、ER、PR、P53、三阴性乳腺癌(Basal-like)、手术方式的差异无统计学意义(P>0.05)。年轻组钼靶X线和彩超乳腺癌检出率分别为45.2%和74.1%。结论年轻女性乳腺癌误诊率高,侵袭性强,pTNM分期晚,Her-2高表达。

Clinical and Pathological Characteristics of 108 Young Women with Breast Cancer

Objective To analyze the clinical and pathological characteristics in young women with breast cancer for instructing the clinical management.Methods The clinical and pathological data of 108 cases of breast cancer with age ≤35 years from 2004 to 2008 were retrospectively analysed and compared with those of 100 cases of breast cancer with age >35 years selected randomly during the same period.All these cases had undergone surgical treatment and been confirmed by pathologist.Results Breast cancer patients with age ≤35 years counted for 8.2% of all breast cancer patients during the same period,and it′s misdiagnosis rate was 39.8%.There were statistically significant differences in the definite time in one month(32.4% vs 48.0%),lymphovascular invasion(12.0% vs 3.0%),the tumor size >5 cm(21.3% vs 8.0%),axillary nodal status 4~9(21.3% vs 10.0%),pTNM stage Ⅲ-Ⅳ(42.6% vs 29.0%),Her-2 positive(41.7% vs 20.0%) between the young group and the middle and old-aged group(P<0.05).Besides,there were no statistically significant differences in the pathological type,histological grade,estrogen receptors(ER),progestogen receptors(PR),protein expression of P53,triple-negative breast cancer(Basal-like) and the kind of surgery(P>0.05).Mammography and breast ultrasonography cancer detection rate were 45.2% and 74.1% respectively in the young group.Conclusion As young women with breast cancer,the clinical and pathological characteristics were high misdiagnosis rate,strong invasion,pTNM stage late,high expression of HER-2.