乳腺原位癌的临床诊治分析

目的探讨对乳腺原位癌早期诊断和治疗的方法。方法对我院2002年1月至2006年12月间29例乳腺原位癌的临床资料进行回顾性分析。结果206例乳腺癌中乳腺原位癌29例,占14.08%;术前乳腺钼靶摄片27例,其中20例阳性,阳性率74.07%;15例有单孔乳头血性溢液,行乳腺导管造影均为阳性;乳腺彩超15例中9例阳性,阳性率60%。术后病理诊断乳腺导管原位癌23例,小叶原位癌6例。行改良根治术15例,单纯乳房切除术10例,保乳手术4例。所有患者手术后恢复良好,无并发症。术后随访10个月～6年,均未发现肿瘤复发和转移。结论乳腺原位癌的早期诊断需要在临床和乳腺影像学检查发现异常的基础上通过手术活检来实现。保乳手术将是治疗乳腺原位癌的趋势。

Clinical diagnosis and treatment of breast cancer in situ

Objective To investigate the early diagnosis and therapeutic method of breast cancer in situ.Methods From January 2002 to December 2006,the clinical data of 29 cases with breast cancer in situ were analyzed retrospectively.Results Preoperative radiography with molybdenum target tube was in 27 cases.Among them,20 cases was positive and positive rate was 74%.Mammary ductography was positive in all 15 cases with bloody discharge of nipple.Color ultrasonography of breast was positive in 9 of 15 cases,and the positive rate was 60%.Postoperative pathological diagnoses as intracanalicular cancer in situ and locular cancer in situ were 23 and 6 cases respectively.In this group,modified radical operation,simple mastectomy and breast-conserving operation were in 15,10 and 4 cases respectively.All cases had a good recovery after operation.No post-operative complications were found.With postoperative follow-up from 10 months to 6 years,no recurrence and metastasis were seen.Conclusion Clinical manifestation and breast imaging examination are necessary to early diagnosis of breast cancer in situ.Breast conserving operation is a developmental trend for the treatment of breast cancer in situ.