15例乳腺导管内乳头状癌的诊断和治疗

目的探讨乳腺导管内乳头状癌的临床病理特征、诊断与治疗要点.方法对15例乳腺导管内乳头状癌进行临床病理特性分析,结合文献对其临床表现、诊断和治疗原则进行探讨.结果15例乳腺导管内乳头状癌主要表现为乳腺局部肿块或伴乳头溢血,影像学检查表现为扩张导管内不规则实性中低回声光团,部分病灶内可见沙粒样钙化点.免疫组化 SMA 、Calponin 和 p63显示肌上皮缺如或不连续;高相对分子质量细胞角蛋白 CK5/6在癌组织未见表达.结论乳腺导管内乳头状癌是一种低度恶性肿瘤,预后较好.单纯乳腺导管内乳头状癌或伴导管内原位癌彻底切除肿瘤及其周围部分乳腺组织已属充分治疗,伴微浸润者宜按照浸润性导管癌治疗.

Diagnosis and treatment of 15 cases with intraductal papillary carcinoma of breast

Objective To discuss the clinicopathological features,diagnosis and treatment of intraductal papil lary carcinoma of breast. Methods The clinical,histological and immunohistochemical data of 15 cases with intraduc- tal papillary carcinoma of breast were collected and analyzed,and related literatures were reviewed. Results The main complaints were mass and drainage of nipple. The main image finding with US was low echoing mass in the expanded duct. Part of cases had little calcifications. Immunostaining of SMA, Calponin and p63 showed that myoepithelium was absent or discontinuous. The Cancerous epithelium showed no or little expression of CK 5/6. Conclusion Intra- ductal papillary carcinoma of breast is a low-grade malignant tumor with good prognosis. Total remove of the tumor and surrounding breast tissues are enough for pure intraductal papillary carcinoma and intraductal papillary carcinoma with DCIS. Intraductal papillary carcinoma with microinvasion cases should be treated as invasive breast cancer cases.