乳腺钼靶伴有倾向恶性钙化的乳腺癌患者保乳术后的预后分析  

The survival outcome of breast cancer patients with potentially malignant calcification on mammography receiving breast-conserving surgery

作　　者：陈翱翔[1] 孟然[1] 齐晓敏[1] 曹旭晨[1] Aoxiang CHEN Ran MENG Xiaomin QI Xuchen CAO(The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin＇s Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin 300060, Chin)

机构地区：[1]天津医科大学肿瘤医院乳腺一科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市恶性肿瘤临床医学研究中心,乳腺癌防治教育部重点实验室,天津市300060

出　　处：《中国肿瘤临床》2016年第17期761-765,共5页Chinese Journal of Clinical Oncology

摘　　要：目的：回顾性分析乳腺钼靶伴有倾向恶性钙化以及不同年龄的乳腺癌患者行保乳术后的预后。方法：收集2005年1月至2008年12月436例天津医科大学肿瘤医院行保乳术的乳腺癌患者的临床病理资料。根据患者乳腺钼靶中是否伴有倾向恶性钙化分为钙化组（122例）和对照组（314例）。根据年龄大小分为年轻组（年龄≤35岁），中年组（36～55岁），老年纽（年龄〉55岁）3个亚组。单因素生存分析采用Logrank法，多因素分析采用Cox回归模型。结果：乳腺钼靶伴有倾向恶性钙化是保乳患者的局部复发及总生存的独立危险因素。亚组分析显示，年轻患者中钙化组患者发生复发、转移及死亡事件的例数较对照组多；中年患者中钙化组局部无复发生存及总生存均较差，差异具有统计学意义；老年患者中有无倾向恶性钙化不影响患者的局部无复发生存及总生存。结论：乳腺钼靶伴有倾向恶性钙化是乳腺癌患者保乳术的局部复发及总生存的独立危险因素。对于老年患者钼靶伴有倾向恶性钙化不应作为其保乳的禁忌证。Objective： To investigate the outcome of breast cancer patients with potentially malignant calcification receiving breastconserving surgery, as well as the results of patients in different age levels. Methods： This retrospective study reviewed the medical records of 436 patients who underwent breast-conserving surgery in Tianjin Medical University Cancer Institute and Hospital between January 2005 and December 2008. Of the 436 patients, 122 were assigned as the calcification group because they had potentially ma- lignant calcification on mammography, whereas the remaining 314 patients were assigned as the control group. Patients were classi- fied into three subgroups based on their ages, namely, young-aged subgroup （aged ~〈35 years old）, middle-aged subgroup （aged 36-55 years old）, and old-aged subgroup （aged 〉55 years old）. Results： Potentially malignant calcification on mammography is a significant prognosis factor of Iocoregional recurrence-free survival （LRFS） and overall survival （OS）. In the young-aged patients, a higher incidence of positive events （relapse, metastasis, and death） was observed in the calcification group. The outcomes of patients with potentially malignant calcification on mammography were worse than those without in the middle-aged subgroup. No significant difference in LRF5 and OS was observed in the old-aged patients between the calcification and control groups. Conclusion： Potentially malignant calcification on mammography was an independent prognosis factor of LRFS and OS in breast cancer patients receiving breast-conserving surgery. In the old-aged patients with breast cancer, potentially malignant calcification on mammography should not be regarded as a contraindication to breast-conserving surgery.

关 键 词：乳腺癌 保乳术 年龄 倾向恶性钙化 

分 类 号：R737.9[医药卫生—肿瘤]