隐匿性乳腺癌36例诊治分析

回顾分析临沂市肿瘤医院乳腺外科收治的36例隐匿性乳腺癌(OBC)患者的临床资料,并结合文献进行讨论。所有病例腋下肿物均经切检病理确诊。乳腺钼靶检查2例诊断为乳腺癌,3例患者为可疑乳腺癌;乳房彩超检查1例诊为乳腺癌,3例患者为可疑乳腺癌。行改良根治术28例,乳腺癌根治术4例,保留乳房手术2例,腋窝淋巴结清除加全乳放疗2例。30例患者获得随访,15例生存时间>5年。回顾分析结果提示,对腋下肿块应行切除活检以明确诊断;乳腺钼靶、彩超及腋下肿物激素受体检测有一定价值;乳腺核磁共振扫描能够提高OBC的检出率。手术方式宜采用改良根治术或保留乳房后全乳照射,并辅以化疗及内分泌治疗等以提高长期生存率。

Diagnosis and treatment of occult breast cancer:analysis of 36 cases

Thirty-six patients with occult breast cancer were treated in our hospital,the data was analysed retrospectively and the literature was reviewed.All the 36 patients were performed excision of the axillary lymph node and confirmed by pathology.Mammography was positive in 2 cases and suspicious in 3;Ultrasound was positive in 1 case and suspicious in 3.Twenty-eight cases were performed modified mastectomy,radical mastectomy for 4,breast conservative surgery for 2 and complete axillary lymph node dissection plus whole breast radiation for 2.Thirth patients were followed-up,among thum,and 15 cases survived over 5 years.According to the results of retrospective analysis.For the patients with axillary lymph node metastasis from unknown primary,a excisional biopsy should performed.Mammography,ultrasound and ER,PR examination of the axillary lymph node had a certain clinicai value.MRI can increase the detecting rate of the occult breast cancer.The treatment should adopt modified mastectomy or breast conservative surgery plus whole breast radiation.Adjuvant chemotherapy and endocrine therapy improve the long-term survival rate.