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隐匿型乳腺癌(Occult breast cancer,OBC)是以腋窝淋巴结转移癌为主要表现的一种少见的乳腺癌表现。对于这类患者应当进行完善的术前检查,不仅需要包括标准的双侧乳腺摄影片,还要通过超声和核磁共振评估双侧乳腺和腋窝淋巴结,以寻找原发病灶。由于此类患者具有较高的局部复发风险,因此不推荐单纯对乳腺进行观察,乳房局部治疗应包括全乳切除,也可以考虑保留乳房联合全乳放疗。同时也应进行腋窝淋巴结清扫以提高局部控制并且完善分期。此外,患者还可以接受新辅助或辅助全身治疗。虽然隐匿性乳腺癌伴腋窝转移患者的疾病分期为T_0N_(1-2)M_0期,但比同期别原发性乳腺癌预后更好,腋窝淋巴结转移数目,尤其是小于4枚转移与4枚或以上转移相比仍然是最为可靠的预测结局的因素。
Occult breast cancer (OBC) is a rare manifestation of breast cancer that is characterized mainly by axillary lymph node metastases. For such patients should be perfect preoperative examination, not only include the standard bilateral mammography, but also by ultrasound and MRI bilateral breast and axillary lymph nodes to find the primary lesion. Because such patients have a high risk of local recurrence, it is not recommended to simply observe the breast, local treatment of breast should include resection of the whole breast, breast conserving combined with whole milk may also be considered. Axillary lymph node dissection should also be performed to improve local control and improve staging. In addition, patients may receive neoadjuvant or adjuvant systemic therapy. Although the stage of disease in patients with occult breast cancer and axillary metastasis is T 0N 1-2 (M 0) stage, the prognosis is better than that of primary breast cancer in the same period. The number of axillary lymph node metastases, especially less than 4 metastases and 4 or The above transfer is still the most reliable predictor of outcome.