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目的隐匿性乳腺癌(occult breast cancer,OBC)是一种少见类型的乳腺癌,OBC发病率较低,缺乏大样本的临床研究,因而在诊断和治疗上存在较多争议。本研究回顾性分析9例OBC患者的临床资料,探讨OBC的诊断、治疗及预后。方法选取解放军总医院2013-08-27-2015-01-23收治的OBC患者9例。患者均为女性,平均年龄50.7岁,中位年龄52岁。本组均因腋下无痛性肿块而就诊,穿刺病理确诊为淋巴结转移性腺癌。6例行乳腺癌改良根治术,3例行腋窝淋巴结清除术。结果 9例患者术后病理均确诊为OBC,3例经全乳连续切片发现原发癌灶。TNM分期:T0N1M05例,T0N2M01例,T0N3M03例。全组9例均获随访,随访时间为11~28个月。除1例死亡外均无瘤生存至今,未见局部复发和远处转移。结论 OBC是乳腺癌的一种特殊类型,发病隐匿,但预后好。以腋下无痛性肿物而就诊的中老年女性应考虑OBC的可能。穿刺病理结合免疫组化可以帮助确诊。乳腺MR是术前筛查乳腺内原发灶的最敏感方法。治疗应以手术为主,术后加做全身的辅助综合治疗。
Objective Occult breast cancer (OBC) is a rare type of breast cancer, OBC incidence is low, the lack of large sample clinical studies, and therefore there are more controversial diagnosis and treatment. This study retrospectively analyzed the clinical data of 9 patients with OBC and discussed the diagnosis, treatment and prognosis of OBC. Methods Select 9 cases of OBC patients admitted to PLA General Hospital 2013-08-27-2015-01-23. All patients were female, with an average age of 50.7 years and a median age of 52 years. This group were due to underarm painless mass treatment, puncture pathology diagnosed as lymph node metastatic adenocarcinoma. 6 cases of modified radical mastectomy, 3 cases of axillary lymph node dissection. Results All the 9 patients were diagnosed as OBC by pathology, and 3 cases were found by serial section of the whole milk. TNM staging: T0N1M05 cases, T0N2M01 cases, T0N3M03 cases. All 9 patients were followed up for 11-28 months. In addition to 1 case of death were outside the tumor-free survival so far, no local recurrence and distant metastasis. Conclusion OBC is a special type of breast cancer, occult onset, but the prognosis is good. Middle-aged and elderly women who have painless underarm should consult OBC. Puncture pathology combined with immunohistochemistry can help diagnose. Breast MR is the most sensitive method of preoperative screening of primary lesions in the breast. The treatment should be based on surgery, postoperative plus the whole body to assist the comprehensive treatment.