12例原发性乳腺鳞癌的临床分析  

Clinical analysis of 12 cases with primary squamous cell carcinoma of the breast

作　　者：冯莉[1] 陈国际[1] 王一澎[1] 张扬[1] 王翔[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院乳腺外科,北京100021

出　　处：《癌症进展》2014年第5期424-428,共5页Oncology Progress

摘　　要：目的回顾性分析乳腺鳞癌的临床特点及预后。方法分析12例原发性乳腺鳞癌的临床病理特征、治疗方法及生存情况。结果 1999年至2014年,我院共治疗20750例乳腺癌患者,其中乳腺鳞癌患者12例(0.058%)。中位发病年龄为52岁;Ⅰ期2例,ⅡA期6例,ⅡB期1例,ⅢA期3例。9例患者予改良根治术,2例予保乳术,1例因局部晚期予全乳切除+淋巴结清除术;4例予术后放疗,9例予术后化疗,3例予内分泌治疗。随访到2014年7月,4例因年代久远失访;1例患者于术后4年发生肺、胸骨、肝和脑的多发转移,行曲妥珠单抗+托瑞米芬治疗1年,带瘤生存4年;1例保乳术8个月后局部复发予乳腺全切后无瘤生存6年;2例分别于术后7个月、3年出现肺转移,经多程化疗分别于11个月后、3年后死亡;余4例均无复发转移,无瘤生存期最长者157个月,短者7个月。结论乳腺鳞癌发生率低,治疗多联合改良根治术和术后辅助治疗。Objective To evaluate the clinical characteristics, treatment modalities and prognosis for primary squamous cell carcinoma of the breast. Method Twelve patients of primary squamous cell carcinoma of the breast were retrospectively analyzed. Result Squamous cell carcinoma of the breast accounted for 0.058%（12/20750） of all breast cancer in our hospital from 1999 to 2014. The age of the 12 cases ranged from 31 to 73 years, with a median age of 52 years old. Two patients were in stage I, 6 in stage IIA, 1 in stage IIB and 3 in stage IIIA. Nine patients underwent the modified radical mastectomy, 2 accepted breast-conserving surgery. Four patients received postoperative radiotherapy, 9 were administered with adjuvant chemotherapy and 3 had endocrine therapy. Eight patients had the whole follow-up data, in which 1 patient survived 4 years with stable disease after treated by trastuzumab plus toremifene for multiple metastases after operation. One patient underwent salvage mastectomy for the local relapse after breast-conserving surgery and was still alive without disease for 6 years. Two patients died of lung metas-tases, and survived 11 and 36 months after more courses of chemotherapy, respectively. The other four patients were alive without diseases. The follow-up ended at July 2014. The disease-free survival ranged from 7 to 157 months.Conclusion The incidence of primary squamous cell carcinoma of the breast is rare. Combination of mastectomy and adjuvant therapy are needed.

关 键 词：乳腺鳞癌 手术治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]