乳腺中央型及外周型乳头状瘤癌变的外科治疗  

Surgical Treatment of Breast Carcinoma Associated with Central Papillomas and Peripheral Papillomas

作　　者：刘伟[1] 韩芸蔚[1] 温绍艳[1] 王欣[1] 

机构地区：[1]天津医科大学附属肿瘤医院乳腺一科,乳腺癌防治教育部重点实验室,天津市肿瘤防治重点实验室,天津市300060

出　　处：《中国肿瘤临床》2011年第10期579-582,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:初步探讨乳腺导管内乳头状瘤(IP)癌变和乳头状瘤病(IPS)癌变的临床表现、诊治及预后。方法:对天津医科大学附属肿瘤医院自2002年1月至2006年12月5年间收集的35例IP癌变和54例IPS癌变患者临床资料进行回顾性分析。结果:所有患者均行超声、钼靶检查,并接受手术治疗。IP癌变为导管内癌20例,早期浸润癌15例;IPS癌变为导管内癌42例,早期浸润癌12例。二者均行保乳+腋窝淋巴结清扫/未腋清或全乳切除+腋清/未腋清。IP癌变行放化疗的比例占45.71%,IPS癌变行放化疗的比例占59.26%。IP癌变患者有l例腋窝淋巴结阳性,IPS患者有3例腋窝淋巴结阳性,所有病例阳性淋巴结数目均为l枚。术后随访3～8年,只有1例术后胸壁复发,余均无复发和转移。结论:IP癌变和IPS癌变均为原位癌或早期浸润癌,且发病率低,预后较好。根据病变范围选择安全手术方式,对腋窝淋巴结建议行前哨淋巴结活检。Objective： To approach the clinical situation, diagnosis, treatment, and prognosis of breast carcinoma associated with intraductal papilloma （ IP ） and intraductal papillomatosis （ IPS ）. Methods： Thirty-five cases of breast carcinoma from IP and 54 cases of breast carcinoma from IPS were retrospectively studied. Results： All patients were examined by mammography and ultrasonography before they underwent surgery. There were 20 cases of ductal carcinoma in situ and 15 cases of invasive carcinoma associated with IP, and 42 cases of ductal carcinoma in situ and 12 cases of invasive carcinoma associated with IPS. They all received breast-conserving surgery or mastectomy with/without axillary lymph node dissection. Adjuvant chemotherapy and radiotherapy accounted for 45.71% and 59.26% in the IP and IPS groups, respectively. There was one case of positive axillary lymph nodes in the IP group and three cases of positive axillary lymph node in the IPS group. All these cases had only one positive lymph node. All patients were followed up 3-8 years post-operation. Chest wall recurrence was observed in only one case, which had positive margin. Conclusion： Breast carcinomas associated with IP and with IPS are rare and have good prognosis. Safe surgical procedures with clean margins are necessary, and sentinel lymph node dissection is recommended.

关 键 词：乳腺癌 导管内乳头状瘤 乳头状瘤病 外科治疗 

分 类 号：R737.9[医药卫生—肿瘤]