隐匿性乳腺癌45例临床分析  

Diagnosis and treatment of occult breast cancer in 45 cases

作　　者：魏云涛[1] 

机构地区：[1]辽宁省肿瘤医院乳腺外科二组,110042

出　　处：《中国实用医药》2013年第9期12-13,共2页China Practical Medicine

摘　　要：目的分析隐匿性乳腺癌的临床特点,总结其诊治经验。方法回顾性分析45例隐匿性乳腺癌患者的临床资料。结果 45例患者均以腋下肿大淋巴结为首发症状,组织病理(28例穿刺活检,17例切取活检)证实为转移性腺癌;37例行改良根治术,6例行腋窝淋巴结清扫术,2例仅行腋下肿物切除术;术后继续治疗43例,20例穿刺活检患者行新辅助化疗,术后继续使用有效的同方案辅助化疗、放疗,另25例术后辅以放疗、化疗;35例行内分泌治疗,其中2例仅行内分泌治疗;随访1～9年,41例生存,7例局部复发,4例死亡。结论对于腋下淋巴结肿大为首发症状,应警惕隐匿性乳腺癌的可能,应行病理活检。隐匿性乳腺癌应采取腋窝淋巴结清扫术后全乳放疗或乳腺癌改良根治术,辅以化疗、放疗、内分泌等综合治疗。Objective To summarize the characteristic, diagnosis and treatment of occult breast cancer （OBC）. Methods We retrospectively analyzed 45 cases of OBC who were treated in our department during 2001 to 2010. Results All the cases who initially presenting axillary mass alone were presenting with axillary metastasis of unknown primary origin. Of the 45 patients, 37 underwent mastectomy plus axillary lymph node dissection （ALND） with or without post-mastectomy radiation （ Mast ＋ ALND）, 6 underwent ALND followed by ipsilateral breast radiotherapy （ BR ＋ ALND） and the remaining 2 was treated with simple axillary node ex- cision. Two of 35 cases who received adjuvant endocrine therapy were only treated with endocrine therapy,g3 cases received adjuvant chemotherapy. Follow-up,ranging from 1 ~ 9 years, was available in 45 cases. 36 were alive without evidence of recurrence or metastases at the time of analysis. 5 cases were still alive with local recurrence and 4 cases died of distant metastases at the time of analysis. Conclusion OBC should be take into ac- count in cases presenting with axillary metastasis of unknown primary origin. The biopsy must be taken. The treatment of OBC should include Mast ＋ ALND/BR ＋ ALND with or without adjuvant chemotherapy and endocrine therapy.

关 键 词：隐匿性乳腺癌 诊断 治疗 

分 类 号：R737.9[医药卫生—肿瘤]