乳腺恶性叶状肿瘤6例临床病理分析

目的探讨乳腺恶性叶状肿瘤的临床病理特点、诊断、鉴别诊断及治疗。方法收集2009～2013年东莞市人民医院及东莞市莞城人民医院收治的6例乳腺恶性叶状肿瘤，对其临床病理资料进行回顾性分析。结果4例患者确诊恶性前有多次手术治疗史及复发史，2例为首诊。末次手术乳腺区段切除1例,单纯乳腺全切除加前哨淋巴结探查2例，改良根治术3例；术后化疗2例，术后双肺转移及死亡1例，其余5例术后随访5个月～4年无复发和转移。结论乳腺恶性叶状肿瘤诊断主要依据病理学，免疫组化具有一定的辅助作用和鉴别诊断作用。大部分由良性或交界性反复复发后恶变，手术切除为主要治疗方式，手术切除范围和复发有一定关系。

Clinicopathological analysis of 6 cases of malignant phyllodes tumors of the breast

Objective To investigate the clinicopathological features, diagnosis, differential diagnosis and treatment of malignant breast phyllodes tumors. Methods We collected the data of the 6 cases of malignant breast phyllodes tumors admitted in Dongguan People＇s Hospital and Guancheng Hospital from 2009 to 2013 and analyzed retrospectively their clinicopathological data. Results 4 cases with definite diagnosis of malignancy underwent multiple surgical treatments and relapses, and 2 cased were diagnosed the first time. In the last surgery, 1 case underwent segmental mastectomy; 2 cases underwent total mastectomy with exploration of sentinel lymph nodes; 3 cased underwent modified radical surgery. 2 cases were treated with postoperative chemotherapy. 1 case died of postoperative metastasis to bilateral lungs. The balance 5 cases had no relapses or metastasis during the postoperative follow-up of 5 months to 4 years. Conclusion Malignant breast phyllodes tumors were diagnozed mainly on basis of pathology and immunohistochemisty helped in diagnosis and differential diagnosis. Most malignancies resulted from repeat relapses of benign or borderline breast tumors. Surgical resection was the main treatment. Resection extent related to relapses.