乳腺叶状肿瘤的诊断及治疗

目的探讨乳腺叶状肿瘤的诊断和治疗.方法对经手术和病理诊断的48例乳腺叶状肿瘤的临床病理资料进行回顾性分析.结果48例中平均年龄为43.2岁.根据肿瘤生长方式,瘤细胞异型,核分裂和肿瘤坏死进行乳腺叶状肿瘤分级,良性26例,交界性12例,恶性10例.全部病例采用手术治疗,肿瘤单纯切除术23例,良性、交界性、恶性复发分别为3/18、2/3、2/2;肿瘤扩大切除术15例,良性、交界性、恶性复发分别为0/8、1/5、1/2;乳房切除术10例,交界性、恶性复发转移分别为0/4、2/6.结论乳腺叶状肿瘤可分良性、交界性和恶性三种类别,确诊和分级主要依靠病理组织检查.提示首次肿瘤彻底切除是治疗的关键,应根据组织分级及肿瘤大小决定手术方式.

Diagnosis and management of phyllodes tumor of breast

Objective To evaluate the diagnosis and treatment of phyllodes tumor of breast.Methods Histophathology data from 48 patients with phyllodes tumor confirmed surgically and phthologically were analyzed retrospectively.Results The mean age of 48 cases was(43.2).It is diagnosed and classified the breast phyllodes tumor according to the involvement of tumor margin,stromal cellar atypia,mitotic activity,stromal overgrowth and necrosin.26 cases of benign tumor,12 cases of borderline tumor and 10 cases of malignant tumor.23 cases underwent total excision,the local recurrence rate of benign,borderline and malignant was 3/18,2/3 and 2/2 respectively;15 cases underwent wide excision,the local recurrence rate of benign,borderling and malignant was 0/8,1/5 and 2/2 respectively;10 cases underwent mastectomy,the recurrence rate of borderline and malignant was 0/4 and 2/6 respectively.Conclusion The breast phyllodes tumor can be classified as the following three types: benign,borderline and malignant.Pathology examination of tumor tissue provided most evidence for final diagnosis and classification.The different surgical operation should be performed according to the different classification and size of breast tumor.