乳腺浸润性微乳头状癌的临床研究

目的研究乳腺浸润性微乳头状癌的临床特点。方法回顾分析我院2007年1月～2011年7月共581例浸润性导管癌患者资料,其中18例乳腺浸润性微乳头状癌,进行临床资料和病理资料的分析研究。结果乳腺浸润性微乳头状癌占乳腺浸润性导管癌的3.1%,患者平均年龄53.2岁,无特殊的主诉、病史和体检,B超一般提示为低回声结节或实性占位,肿块多有丰富彩色血流信号(9/10)。钼靶BI-RADS分级高I,V级以上的有15例(15/18)。均行乳腺癌改良根治术,有脉管浸润的有10例,占55.6%。伴有同侧腋窝淋巴结转移的有13例,占72.2%;术后病理分期I,期的有5例I,I期的有4例I,II期的有9例。术后根据病理情况行化放疗和内分泌治疗。随访16例,时间2～45个月,均未发现复发和远处转移。结论乳腺浸润性微乳头状癌无特殊的临床表现和影像学表现,但B超和钼靶多有恶性表现。乳腺浸润性微乳头状癌具有高的淋巴结转移率和术后病理分期,术后适当的综合治疗可能延长患者的无病生存期。

Clinical research of invasive micropapillary carcinoma of breast

Objective To research the clinical characteristics of invasive micropapillary carcinoma（IMPC） of breast.Methods 581 cases were selected from January 2007 to July 2011 in our hospital.18 of them were IMPC.Their clinical materials were analyzed and studied.Results The occurrence of IMPC was 3.1%.The average age was 53.2 years without special clinical characteristics.In terms of sonography,the common findings were of hypoechoic nodules or mass with abundant bloodstream wink（9/10）.Mammography imaging of IMPC had high grade BI-RADS and 15 cases（15/18） exceeded grade IV.The incidence of metastases of the lymph node was 72.2%（13/18）,（mean 6.2）.There were 5 cases of stage I,4 cases of stage II and 9 cases of stage Ⅲ.Follow-up was available in 16 patients.Everyone was alive without local recurrences and distant metastases.Conclusion IMPC has no exceptional clinical manifestation and imaging characteristics.But mammography imaging characteristics of IMPC were high suggestive of malignancy with high grade BI-RADS.IMPC has high incidence of metastases of the lymph node and late pathological stage.Properly comprehensive treatment after operation would do good to prolong the free survival of patients.