乳腺Paget病诊断及治疗  

Diagnosis and treatment of Paget disease of the breast

作　　者：张弛[1] 段学宁[1] 

机构地区：[1]北京大学第一医院乳腺疾病中心,北京100034

出　　处：《中国实用外科杂志》2013年第3期184-186,共3页Chinese Journal of Practical Surgery

摘　　要：乳腺Paget病是乳腺癌的一种少见形式,表现为乳头乳晕复合体病变并常伴有乳腺原位癌或浸润性癌。关于Paget肿瘤细胞起源仍有较多争论。病人术前详细体检和影像学检查对于评估病灶和选择手术方式十分重要,磁共振成像(MRI)有较高应用价值。一直以来,全乳切除是根治Paget病的标准手术方式,近来研究表明甄选合适病人接受保留乳房手术对预后无显著影响。前哨淋巴结活检在Paget病中同样有较高准确性和较低假阴性率。Paget disease of the breast is a rare disorder of the nipple-areola complex that is often associated with an underlying in situ or invasive carcinoma. The histogenesis of Paget disease of the breast continues to be debated. Routine preoperative assessment, including physical exam, mammography, ultrasonography and magnetic resonance imaging should accurately assess the extent of Underlying cancer in patients with Paget disease of the breast. Magnetic resonance imaging is of great important. Mastectomy has been considered the standard of care in the management of patients with Paget disease of the breast. Nowadays, however, some patients with Paget disease of the breast are candidates for breast-conserving therapy. Patients must be selected carefully on an individual basis. Sentinel lymph node biopsy has a high accuracy and low false-negative rate in Paget disease and should be performed in all patients.

关 键 词：PAGET病 保留乳房手术 前哨淋巴结活检 

分 类 号：R6[医药卫生—外科学]