摘要
背景与目的:早期诊断是提高乳腺癌治疗疗效的关键,乳腺癌病理分期越早,临床症状越不典型,本研究回顾性分析了临床体检未触及肿块(包括乳房及腋淋巴结均未触及肿块)乳腺癌诊断的方法与特点,以期提高乳腺癌的早期诊断率。方法:收集2006年9月—2009年3月期间收治的共115例体检未触及肿块的乳腺癌患者的临床检查资料,包括乳头溢液、钼靶X线片、超声检查的情况,并分析其病理特征及肿瘤分期情况。结果:115例患者(117侧乳房)中,原位癌(包括导管原位癌、导管上皮内肿瘤、小叶原位癌、神经内分泌性导管内癌、大汗腺性导管内癌)占33.3%,微小浸润性导管癌占22.2%,浸润性癌占44.5%。20例(22侧)单纯乳头溢液患者原位癌11侧,占50%;微小浸润导管癌3侧,占13.6%;浸润性癌8例(包括浸润性导管癌7例,粘液腺癌1例),占36.4%。34例单纯钼靶表现异常者中原位癌(15例)和微小浸润导管癌(11例)共占76.5%。浸润性癌占23.5%;19例单纯表现为B超结节者中原位癌占31.6%,浸润性导管癌比例高达68.4%。乳头溢液伴钙化灶者,原位癌占50.0%;乳头溢液伴B超结节者,原位癌占33.3%;B超结节伴钙化灶,以及乳头溢液伴B超结节与钙化灶者,原位癌均占50.0%。术后病理分期情况,0～Ⅰ期96例(98侧)占83.8%,Ⅱ期15例,Ⅲ期4例;腋淋巴结转移1～3枚的11例,4～9枚的3例,>10枚的1例。结论:乳房体检乳腺未触及肿块时,要重视B超、钼靶等影像学检查及乳头溢液的临床检查,其中一项异常,应积极进一步诊治。
Background and purpose： Early diagnosis is very important for the treatment of the breast cancer. The earlier pathologic stage the disease belongs to, the more atypical the clinical symptoms will be. In order to increase early diagnosis of the cancer, we retrospectively analyzed the methods of early diagnosis for nonpalpable breast cancer （including both nonpalpable breast tumor and lymph node）. Methods： From Oct. 2006 to Mar. 2009, 115 patients with nonpalpable breast tumors were analyzed retrospectively for nipple discharge, mammography and ultrasound as well as pathological characteristics and the stages of carcinoma. Results： In the 115 patients （117 sides）, carcinoma in situ （CIS） was 33.3%（39/117）, including ductal carcinoma in situ （DCIS）, ductal intraepithelial neoplasia （DIN）, lobular carcinoma in situ （LCIS）, neurosecretory carcinoma in situ （NCIS） and large sweat gland carcinoma in situ （LSGCIS）; DCIS with local micro invasion （DCIS-MI） was 22.2%; invasive carcinoma （IC） was 44.5%. In 20 cases （22 sides） with unilateral nipple discharge, CIS was 50%, DCIS-MI was 13.6% and IC was 36.4%, respectively. In 34 cases with only mammography disorder, 76.5% was DCIS and DCIS-MI, and 23.5% was IC, respectively. In 19 cases with only masses by ultrasonography, 31.6% was CIS and 68.4% was IC, respectively. Carcinoma in situ accounted for 50% in patients with calcification and mass detected by ultrasound, and 50% in patients with nipple discharge, calcification and mass detected by ultrasound. Postoperatively, 96 patients （98 sides） were in stage 0- Ⅰ （83.8%）, 15 in stage Ⅱand 4 in stage Ⅲ. 11 cases with 1-3 lymph nodes metastasis, 3 cases with 4-9 lymph nodes metastasis and 1 case over 10 lymph nodes metastasis. Conclusion： Imaging examinations such as ultrasound and mammographic screening as well as clinical examination of nipple discharge should be paid attention to health examination of breast with nonpalpable mass and more examinations should be applied if there had any abnormal results in the examinations mentioned above.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2009年第11期864-867,共4页
China Oncology
关键词
乳腺癌
体检不可触及病变
早期诊断
breast cancer
nonpalpable breast lesion
early diagnosis
