157例35岁以下女性乳腺癌的预后分析

目的 分析青年期乳腺的临床和病理学特点以及这些因素对生存期的影响。方法 对1962－1993年间157例青年期乳腺癌作回顾性总结，分析病理类型、肿瘤大小、腋淋巴结情况、TNM分期与生存率的关系，以及妊娠乳腺癌的预预后。结果 发病率占同期乳癌人群的8．9％，十年 生存率45．9％。肿瘤＞3cm，腋淋巴结转移82．5％。十年生存率22．4％；肿瘤≤3cm，腋淋巴结转移45．9％，十年生存率59．6％（P＜0．001）。腋淋巴结转移数量≥4枚，5年内死亡率高达61．8％。Ⅱb期以早的病人五年生存率83．0％，Ⅲa期以后的病人五年生存率31．1％。妊娠或产后1年内乳腺癌十年总生存率51％。结论 青年期乳腺癌与年长内乳腺癌十年总生存率51％。结论 青年期乳腺癌与年长组相比不更差的预后、肿瘤大小与腋淋巴结转移以及数量呈正相关，肿瘤大小、腋淋巴结转移数量与生存率负相关。Ⅱb基以早病人显示良好预后。妊娠或产后1年内乳腺癌预后并不差。手术范围扩大不体现生存优势。

ANALYSIS OF PROGNOSIS OF BREAST CANCER IN WOMEN UNDER 35 YEARS OF AGE (REPORT OF 157 CASES)

Objective　To analyze the clinical and pathologic characteristics of breast cancer in women aged under 35 years and the influence of these factors upon survival.Methods　From 1962 to 1993,a retrospective study of 157 breast cancer patients younger than 35 years was made to analyze the relationship between the survival rate and the pathological type, tumor size,axillary lymph nodes and UICC (TNM) system.The prognosis of breast carcinoma in pregnant women was also studied.Results　Breast carcinoma in younger women was occupied approximately 8.9% of all breast cancer cases .Overall 10-year survival rate was 45.9%.When tumor was over 3 cm with 82.5% axillary nodes metastasis, the 10-year survival rates was 22.4%；when tumor ≤3cm with 41.8% axillary nodes metastasis the 10 -year survival rate was 59.6%(P＜0.001).When number of axillary node≥4,the 5-year death rate was as high as 61.8%.The 5-year survival rate was 83.0% in patients with tumor stage earlier than Ⅱb only 31.1% in cases later than Ⅲa .The 10-year survival rate of patient with breast cancer during pregnancy ofr within one year after delivery was 51%.Conclusion　Prognosis of breast cancer in young women is not poorer than in older women.Size of tumor is positively related with axillary node metastasis and number of infiltrated node.Survival rate is negatively related with tumor size and number of infiltrated axillary nodes.Breast cancer patient earlier than stage Ⅱb has much better prognosis,and in pregnant women or within 1 year after delivery the prognosis is not so worse.Extended operations do not bvenefit the survival rate.