乳腺导管内癌的诊断与处理(附41例报告)

目的 提高乳腺导管内癌的诊治水平。方法 对我院1999年6月～2003年6月收治的41例导管内癌患者的诊断和治疗进行回顾性分析。结果 首发症状中,非触摸型导管内癌占75.2％。乳腺X线摄影检查符合率为80％,乳管内视镜检查为95.7％。本组41例术后无皮肤坏死,上肢水肿等并发症。术后随访1～49个月,未发现远处转移及死亡病例。保乳术后局部复发2例(4.88％),均为40岁以下导管内癌伴微浸润患者,其中1例为粉刺型导管内癌。结论 乳腺X线摄影和乳管内视镜检查明显提高了非触摸型导管内癌的检出率。导管内癌保乳术后存在一定的局部复发率,对于年龄小于40岁,粉刺型及伴微浸润的导管内癌患者应慎重选择保乳手术。

Diagnosis and Treatment of Ductal Carcinoma in Situ (A report of 41 cases)

Objective To improve the diagnosis and therapeutic level of ductal carcinoma in situ (DCIS). Methods From June 1999 to June 2003,41 patients with DCIS were analyzed retrospetively. Results 75. 2% of DCIS were impalpable. The diagnostic accuracy of mammograpby was 80% , for fiberoptic ductoscopy it was 95. 65% . There were no skin necrosis and edema of upper limbs in all cases after operation. With follow up 1 to 49 months, no distant metastasis and death case were found. Only 2 cases had local recurrence after breast conservative surgery (4. 88% ) . They were all DCIS with microinvasion and less than 40 years old, one of them was comedo DCIS. Conclusion The diagnostic accuracy of impalpable DCIS was improved obviously by mammography and fiberoptic. Some patients recurred locally after breast conservative surgery, especially for those who were less than 40 years old, and with comedo DCIS or DCIS with microinvasion.