计算机近红外线扫描对乳房肿块诊断初步分析（附47例报告）

４７例乳房肿块，其中乳腺腺病２０例，乳腺囊性增生２例、乳腺癌１５例，乳腺纤维瘤８例、积乳囊肿２例，经过计算机近红外线扫描检查结果与术后病理结果对照得出：近红外线扫描对乳腺良性疾病诊断符号率达８２％，对乳腺癌诊断符合率达７３％，认为计算机近红外线扫描国诊断乳腺疾病不能硬套诊断标准，应结合临床、针吸等全面分析，诊断准确率将会进一步提高。     

计算机近红外线扫描对乳房肿块诊断初步分析（附47例报告）

４７例乳房肿块，其中乳腺腺病２０例、乳腺囊性增生２例、乳腺癌１５例、乳腺纤维瘤８例、积乳囊肿２例。经过计算机近红外线扫描检查结果与术后病理结果对照得出：近红外线扫描对乳腺良性疾病诊数符合率达８２％，对乳腺癌诊断符合率达７３％。认为计算机近红外线扫描诊断乳腺疾病不能硬套诊断标准，应结合临床、针吸等全面分析，诊断准确率将会进一步提高。     

分析肿瘤医院医疗服务投诉，提升服务水平

为探索医疗服务投诉发生的规律,提高医疗质量,回顾性分析中国医学科学院肿瘤医院2009～2011年共126例医疗服务投诉的科室、人员分布及投诉缘由。发生投诉数量前三名的科室依次为腹外科（28例,22．2％）、病案室（19例,15．1％）、胸外科（18例,14.3％）。医疗服务投诉的主要对象中高级职称医师占71％,手术缺陷引起的投诉占30％。医院应针对性狠抓外科手术、高级职称医师、病案管理等,以期不断提高医疗质量和服务质量,提升患者满意度。     

少见乳腺肿块疾病的声像图与术后病理对照分析

目的 对照乳腺肿块术后病理进一步了解少见的、不典型病例的声像图特征。提高B型超声诊断准确率。方法 应用B超常规探查乳腺组织,对乳腺肿块病例进行术后病理追踪。发现少见、不典型病例,复习资料,回顾声像图特点,加深对此类 疾病的认识。结果 发现少见、不典型病例11种,共15例,其中乳腺错构瘤1例;脉管瘤1例;囊虫症1例;外伤性脂肪液化1例;浆液性乳腺炎1例;纤维组织粘液变性1例;异物肉芽肿2例;乳腺硬化型腺病1例;乳管周围炎3例;单纯癌2例;丝虫病1例。这些病例均出现B超诊断错误。结论 尽管B超高频探头探查乳腺良、恶性病变准确,附合率高,但对少见、不典型病例要结合临床、病史分析声像图,必要时穿刺活检方可做出正确诊断。     

印片与快速石蜡切片在乳腺肿块术中病理诊断中的应用

乳腺肿块是临床常见症状,在外科病检工作中,术中快速病理诊断是1项十分重要的工作,常见方法包括:冷冻切片、快速石蜡切片和术中细胞学诊断。我们采用印片法与快速石蜡切片法对照,对乳腺肿块进行术中快速病理诊断,探讨这2种方法对乳腺肿块在术中病理诊断中的应用价值。1材料与方     

乳腺肿块531例临床病理分析

总结了我院１９９３年至１９９６年经病理活检确诊的５３１例乳腺肿块病例。良性病变４５６例，恶性肿瘤７５例，分析了乳腺肿块的发病情况，不同年龄组良，恶性疾病的百分构成和乳腺肿块的病理组织学类型。本组资料揭示：乳腺的良性疾病随着年龄的增加，发病率逐渐下降，而恶性肿瘤的发病率则随年龄的增加在而逐步增高。     

1883例乳腺肿块回顾性分析

目的总结我国最南端三亚热带地区乳腺疾病的发病情况.方法回顾性统计分析1 883例乳腺疾病的临床病理资料.结果非肿瘤性病变694例(36.9%),其中乳腺增生病602例(32.0%).肿瘤性病变1 189例(63.1%),良性肿瘤857例(45.5%),其中乳腺腺纤维瘤833例(44.2%);恶性肿瘤332例(17.6%),其中乳腺癌327例(17.3%).50岁以上181例,占恶性肿瘤发病人数的54.5%.结论乳腺癌总的发病率低于国内其他地区,而50岁以上年龄组高发.     

冰冻切片加印片提高乳腺术中病理诊断准确性98例分析

目的:探讨手术中冰冻切片加印片提高乳腺肿块快速诊断准确性的方法.方法:对98例乳腺肿块手术中快速病检病例,同时进行印片细胞学及冰冻切片检查,并与单独的冰冻切片检查对比.结果:98例乳腺肿块手术中冰冻切片加印片确诊96例,确诊率97.9%,术中冰冻切片确诊84例,确诊率85.7%,两者比较,差异有统计学意义(P＜0.05).结论:将冰冻切片与印片细胞学同时应用于乳腺肿块术中快速病检,与单独的冰冻切片比较,可以提高准确性.     

乳腺癌保乳手术后的放射治疗

早期乳腺癌保留乳腺手术后的放射治疗,是欧美国家治疗早期乳腺癌的主要方法之一。本文综述了这种方法近10年来在照射方法、应用技术、与化疗结合适应证等方面的进展。     

乳腺癌保乳手术联合术后放疗的疗效分析

[目的]探讨保乳手术加放疗治疗Ⅰ、Ⅱ期乳腺癌的效果。[方法]回顾性分析1998年1月-2002年7月在我院接受保乳手术加术后放疗的34例乳腺癌临床资料。[结果]全组随访36-90个月，平均随访63.5个月。3年生存率100%（34/34），3年无瘤生存率97.1%（33/34），随访满5年的24例，5年生存率100%（24/24），5年无瘤生存率91.7%（22/24）。[结论]Ⅰ、Ⅱ期乳腺癌采用保乳手术加放射治疗可取得满意疗效。     

乳腺癌术后皮瓣坏死的原因分析与防治

全文对两组不同方法和术后处理的乳腺癌手术后皮瓣坏死情况进行了分析，对皮瓣坏死的防治提出了几点看法。     

17例乳腺癌保乳手术加放疗分析

[目的]评价乳腺癌保乳手术加放疗的治疗结果及存在问题.[方法]回顾性分析17例保乳术后加放疗的乳腺癌病人临床资料.[结果]全组5年生存率和5年无瘤生存率分别为93.8%和87.1%,5年肿瘤局部控制率为93.8%,有1例死于复发并脑转移,另有1例股骨转移后生存.15例有良好美容效果,2例美容结果一般.[结论]早期乳腺癌采用保乳手术及放射治疗可取得满意结果,强调规范诊治及良好的多学科协作.     

乳腺癌责任保险普查的价值(附86例分析)

本文对1990年以来我们在北京市及近郊区妇女乳腺防癌责任保险普查中所检出的经病理证实的86例乳腺癌，从病变分期、年龄及普查的方法等方面进行了分析。认为通过乳腺癌责任保险连续普查普治，确实能够提高早期癌的检出率，明显降低35岁以下妇女乳腺癌的发生率、普查的重点人群年龄构成为35～60岁，高危年龄组在45～54岁之间。其内容包括：（1）防癌知识宣教；（2）临床触诊，近红外线扫描筛选，重点人群X线拍片等综合普查：（3）普治良性病变．被检人群五年内共普查三次，凡乳房有良性病变者，在治疗同时，3～6个月复查一次．     

乳腺具有钙化灶未触及肿块18例临床分析

乳腺X线片内显示微灶钙化患者18例进行乳腺X线立体定位手术活检,并进行组织学的诊断.     

乳腺癌保乳治疗的临床研究体会

回顾乳腺癌保乳治疗的演变，结合206例实践及学习体会，从病例选择，手术要点，放疗及其它辅助治疗，前哨淋巴结活检，保乳美容评估等方面，探讨保乳综合治疗模式。     

Breast Lymphedema After Conservative Breast Surgery: An Up-to-date Systematic Review

Although arm lymphedema following breast cancer treatment is a common complication; breast lymphedema following treatment is not uncommon. Several risk factors were found to contribute to breast lymphedema, including axillary surgery, high body mass index (BMI), increased bra cup size, adjuvant chemotherapy, locoregional and radiotherapy boost, and upper outer quadrant tumors. We aimed to provide a review to help avoiding or management of breast lymphedema. The search term ‘breast lymphedema’ was combined with ‘breast conservative surgery’ and was used to conduct a literature research in PubMed and Medline. The term lymphedema was combined with breast, conservative, and surgery to search the Embase database. All papers published in English were included with no exclusion date limits. A total of 2155 female patients were included in this review; age ranged from 26 to 90 years. The mean BMI was 28.4 of the studies that included patients who underwent conservative breast surgery. Incidence of breast lymphedema ranged from 24.8% to 90.4%. Several risk factors were linked to breast lymphedema after conservative breast surgery, such as BMI, breast size, tumor size, tumor site, type of surgery, and adjuvant therapy. Treatment options focused on decongestive lymphatic therapy, including manual lymphatic drainage, self-massaging, compression bras, or Kinesio taping. Breast lymphedema is a relatively common complication, yet there is no clear consensus on the definition or treatment options.     

非炎性乳腺癌保乳术后局部炎性复发3例分析

乳腺癌保乳术后炎性复发较少见,约占局部复发的2%,此类病人预后较差,平均生存期小于2年。全文分析3例乳腺癌保乳术后炎性复发患者的病情特征、补救治疗及预后情况。     

Comparison of Long-Term Oncological Outcomes in Oncoplastic Breast Surgery and Conventional Breast-Conserving Surgery for Breast Cancer: A Propensity Score-Matched Analysis

PurposeThe oncoplastic breast-conserving surgery (OPS) technique, combined with the principles of oncological safety and plastic surgery, results in complete tumor resection while preserving the natural appearance of the breast. The purpose of this study was to evaluate the long-term oncological results after OPS compared with conventional breast-conserving surgery (BCS) for early breast cancer.MethodsThe medical records of patients who underwent breast cancer surgery and adjuvant radiation therapy at Seoul National University Hospital between 2011 and 2014 were reviewed. Ipsilateral breast tumor recurrence (IBTR)-free survival rate and recurrence-free survival (RFS) rates were compared between the OPS and BCS groups.ResultsOne-to-one propensity score matching was conducted, yielding 371 patients in each group. The mean tumor distance from the nipple was shorter, and the mean retrieved specimen size and pathologic tumor size, including ductal carcinoma in situ, were larger in the OPS group than in the conventional BCS group (p < 0.001). Surgical margin positivity was not significantly different between the two groups (p = 0.777). The surgical technique was not significantly associated with IBTR (OPS versus conventional BCS, 5-year survival rate, 96.9% vs. 98.6%; p = 0.355) and RFS (5-year survival rate, 92.9% vs. 94.5%; p = 0.357) on the log-rank test. Multivariate analysis revealed that OPS versus conventional BCS was not significantly associated with survival outcomes.ConclusionWe observed no significant differences in long-term IBTR and RFS between the OPS and conventional BCS groups in this retrospective analysis. OPS can be an oncologically and surgically safe alternative option for conventional BCS for early breast cancer.