隐性乳腺癌的诊治(附68例报告)

目的：探讨隐性乳腺癌的发病特点、检诊规范和治疗方法.方法：回顾性分析68例隐性乳腺癌临床病理资料和治疗效果.结果：全组均经腋窝淋巴结活检及免疫组化M4G33检测明确诊断,65例行根治术或改良根治术,3例行腋窝肿块切除,术后全部辅助放、化疗,全组5、10年生存率分别为77.9%和58.12%;术后常规病检原发灶检出率33.8%（22/65）,结合全乳腺次连续大切片检查,病理原发灶总检出率达86.2%（56/65）.结论：对女性腋窝肿块同时排除全身其它部位癌转移者应高度考虑隐性乳腺癌,腋窝淋巴结活检和免疫组化M4G3检测对确诊有重要意义;根治术标本宜行全乳腺次连续大切片检查以提高原发癌灶检出率,治疗宜选择根治术或改良根治术并辅助放疗、化疗以及内分泌治疗.

Diagnosis and Treatment of Occult Breast Cancer

Objective:To investigate the characteristics, diagnosis and treatment of occult breast cancer. Methods:Data of 68 cases with occult breast cancer were analyzed retrospectively. Results:All patients of the group received biopsy and immunohistochemical M4G3-test, among which radical or modified mastectomy was conducted in 65 cases and axillary node excision in 3. Postoperative chemotherapy and radiotherapy were carried out in all patients. The 5 and 10-year disease-free survival rate was 77.9% and 58.12% respectively. The detection rate of primary focus was 33.8% (22/65). With the help of subserial section of total breast, the overall detection rate was up to 86.2% (56/65). Conclusion:The occult breast cancer should be taken into consideration in case presented axillary mass with exclusion of the metastasis from other sites. The histological diagnosis such as axillary nodes biopsy and immunohistochemical M4G3-test are the mainstay for final diagnosis of the occult breast cancer. The subserial section examination of total breast is needed for improving the detection rate of primary focus. Radical or modified radical mastectomy with adjuvant radiotherapy, chemotherapy and endocrinological therapy is the treatment of choice for occult breast cancer.