乳腺叶状肿瘤17例诊疗分析

目的:探讨乳腺叶状肿瘤的治疗原则和影响预后因素。方法:对经手术和病理诊断确诊的17例乳腺叶状肿瘤的临床资料进行回顾性分析。结果:17例患者中良性叶状肿瘤9例,交界性叶状肿瘤5例,恶性3例。行局部肿块切除7例,单纯乳房切除术6例,改良根治术3例,姑息性肿块切除术1例。其中随访13例,平均随访时间21(5~84)个月,1例行乳腺癌改良根治术后2.5年死于远处转移,2例行局部肿块切除术后复发。结论:乳腺叶状肿瘤的预后与手术方式有关,良性和交界性应首选扩大区段切除术,切除肿瘤边缘不少于2cm;复发的交界性和恶性应尽早行单纯乳房切除术。

Diagnosis and treatment of 17 cases with phyllodes tumor of breast

Objective:To explore the principle of treatment and prognostic factors of phyllodes tumor of the breast. Methods: Clinical data of 17 patients with phyllodes tumor confirmed surgically and pathologically were analyzed retrospectively. Results: Of the 17 cases of phyllodes tumor , there were 9 cases of benign tumor , 5 cases of borderline tumor and 3 cases of malignant tumor according to the standard histological criteria of WHO. Seven patients underwent local mass excision , 6 cases simple mastectomy , 3 cases modified radical mastectomy ,and 1 case tumor mass excision. Follow-up was obtained for 13 cases, with an average of 21 months. One patient died from metastasis 2.5 years after a modified radical mastectomy. Two patients treated by local mass excision developed local recurrence. Conclusion: Surgical options are closely associated with the out come of phyllodes tumor of the breast .Patients with benign or borderline phyllodes tumor should undergo wide local excision with at least 2cm margins of uninvolved tissue , and patients with local recurrent borderline and malignant phyllodes tumor should receive mastectomy.