隐匿性乳腺癌的诊断和治疗

目的分析隐匿性乳腺癌的诊断、治疗及其预后情况,总结其诊断及治疗经验。方法回顾性分析47例隐匿性乳腺癌的诊断治疗方法以及各种方法治疗的效果。结果23例患者接受了同侧乳腺改良根治术,18例患者仅行同侧腋窝淋巴结清扫术,6例患者在腋窝淋巴结活检证实为隐匿性乳腺癌后未行进一步手术治疗。行改良根治术组与仅行腋窝清扫组两者间总生存率差异无显著性(P=0.646),但后者复发率(33.3%,6/18)明显高于前者(8.7%,2/23),两者无病生存率比较差异有显著性(P=0.008)。结论腋窝淋巴结活检及免疫组化分析对隐匿性乳腺癌的诊断具有重要意义,治疗方式首选改良根治术并辅以化放疗综合治疗。

Diagnosis and therapy of occult breast cancer

Objective To investigate the diagnosis,treatment and outcomes of occult breast cancer(OBC),and summarize the diagnosis and treatment experience.Methods The clinical records of 47 patients diagnosed OBC were retrospectively analyzed.Results Twenty-three patients underwent modified radical mastectomy(MRM),18 patients received axillary lymph node dissection(ALND) and 6 patients accepted radiotherapy/chemotherapy other than surgery.The patients undergoing MRM had significantly(P=0.008) improved disease-free survival rate compared with those who received ALND,while there was no significant difference in overall survival rates between these two groups(P=0.646).Of the 18 patients receiving ALND,6(33.3%) had recurrent disease,whereas only 2 of the 23 patients(8.7%) receiving MRM developed recurrent or metastatic disease.Conclusions Axillary lymph node biopsy and immunohistochemical analysis play important roles in the diagnosis of OBC.Preferred treatment is modified radical mastectomy combined with radiotherapy and chemotherapy.