乳腺导管内乳头状瘤癌变的诊治:附22例报告  

Diagnosis and treatment of carcinomatous change of breast intraductal papillomas:a report of 22 cases

作　　者：张建国[1] 仲雷[1] 郭宝良[1] 

机构地区：[1]哈尔滨医科大学附属二院乳腺外科,黑龙江哈尔滨150086

出　　处：《中国普通外科杂志》2007年第1期41-43,共3页China Journal of General Surgery

摘　　要：目的探讨乳腺导管内乳头状瘤(intraductal papillomas,IP)癌变的临床表现、诊断和治疗。方法回顾性分析近5年多来收治的22例IP癌变患者的临床及病理资料。结果22例IP癌变占同期收治IP患者的4.61%(22/477),占乳腺癌患者的5.96%(22/369)。其中未曾行病理切片检查的20例患者术前均未确诊,术中冷冻切片确诊13例,7例未能确诊。22例中行区段切除2例,乳房单纯切除16例,改良根治术4例(术后病理证实淋巴结均无转移)。结论IP癌变临床表现没有特异性,术前诊断困难,术中冷冻切片有助于确诊。治疗以选择性乳房单纯切除为宜。Objective To investigate the clinical characteristics, diagnosis and treatment of patients with carcinomatous change of breast intraductal papillomas （IP）. Methods The clinical and pathologic data of 22 patients treated from Jan 2000 to Jan 2005 were analyzed restrospectively. Results The 22 patients accounted for 4.61% （22/477） of patients with IP and 5.96% （22/369） of patients with breast cancer during the same period. Tweenty of the 22 patients did not have biopsy, and a definite diagnosis was not made before operation. Frozen section established the diagnosis in 13 of the 20 cases, but was negative in 7 cases. In this series, 2 cases received segmental mastectomy, 16 cases received total mastectomy, and 4 cases received modified radical mastectomy （the post-operative pathology confirmed that no axillary node metastasis was found ）. Conclusions It is difficult to diagnose the carcinomatous change of breast intraductal papillomas before operation, because there are no spelific clinical characteristics, and frozen section is considerable to confirm the diagnosis, and the treatment of choice is simple mastectomy.

关 键 词：乳腺肿瘤/外科学 乳头状瘤 管内 癌 导管 乳腺/继发性 癌 导管 乳腺/诊断 

分 类 号：R737.9[医药卫生—肿瘤]