乳腺髓样癌的治疗

目的探讨乳腺髓样癌临床特征、治疗和预后。方法回顾性分析1995年1月至1999年12月收治的乳腺髓样癌的临床资料。结果26例乳腺髓样癌占同期治疗女性乳腺癌616例的4.2%,年龄31~66(45.8±10.6)岁,肿瘤大小1~5 CM,腋淋巴结阳性率23.1%,腋淋巴结转移的发生与乳腺肿瘤的大小无关,免疫组化检测雌激素(ER)、孕激素(PR)和HER-2/NEU的阳性率分别为26.3%、21.1%和5.3%。全组进行手术和辅助化疗(环磷酰胺、甲氨蝶呤和氟尿嘧啶)。5例服用三苯氧胺,3例进行放射性治疗。随访时间5~9年,平均7.5年,总的5年生存率为88.4%。结论乳腺髓样癌的预后较好,手术加辅助性化疗是治疗的重要手段,分子生物学指标在乳腺髓样癌预后中的作用应该受到足够的重视。

Clinical analysis of medullary carcinoma of the breast

OBJECTIVE: To assess the clinical manifestation, management and outcome in patients with medullary carcinoma of the breast (MBC). METHODS: Retrospective analysis was carried out on patients with MBC who were admitted from January 1995 to December 1999. RESULTS: A total of 616 female patients treated for breast carcinoma, 26 cases (4.2%) were histopathologically confirmed MBC. The mean age was (45.8 +/- 10.6) years. The tumor size was among 1-5 cm and axillary lymph node involvement was 23.1%; there was no statistically significant correlation between tumor size and metastatic axillary lymph node. Estrogen receptor (ER), progesterone receptor (PR) and HER-2/neu assay were performed immunohistochemically, and the overexpression was 26.3%, 21.1% and 5.3% respectively. All patients underwent operation and polychemotherapy (5-fluorouracil, methotrexate, cyclophosphamide), hormone therapy with Tamoxifen was applied in five patients, and three cases received postoperative irradiation. The follow-up period ranged from 5 to 9 years. Overall five-year survival was 88.4%. CONCLUSIONS: MBC is a favorable histological type of breast carcinoma with good prognosis. Operation and chemotherapy are main procedures for MBC. The significance of molecular biologic parameters in the prognosis of MBC should not be overlooked.