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目的探讨乳腺分叶状肿瘤的临床特点、诊治方法和局部复发的危险因素。方法选取1990年1月至2016年7月间柳州市工人医院收治的48例乳腺分叶状肿瘤患者的临床病理和随访资料作回顾性分析,采用卡方检验分析各临床病理因素、手术方式与局部复发的关系,采用Logrank检验分析上述因素对无病生存率的影响。结果所有患者术后病理诊断结果中,良性乳腺分叶状肿瘤29例,交界性乳腺分叶状肿瘤11例,恶性乳腺分叶状肿瘤8例,无一例发现腋窝淋巴结转移。39例随访患者,1年、3年和5年无病生存率分别为83.8%、69.4%和66.1%,5年总生存率为93.0%。局部复发者10例,其中6例患者为肿块切除术后局部复发。患者是否采用肿块切除术与局部复发关系比较,差异有统计学意义(P=0.01)。结论外科手术是乳腺分叶状肿瘤的主要治疗方法,术式选择不当与局部复发有关,对乳腺分叶状肿瘤应选择局部广泛切除、乳房切除或乳房重建术,不宜采用肿块切除术,不必常规行腋淋巴结清扫术。
Objective To investigate the clinical features, diagnosis and treatment of breast lobular tumors and the risk of local recurrence. Methods A retrospective analysis of 48 patients with breast phyllodes tumor from January 1990 to July 2016 in Liuzhou Workers’ Hospital was conducted. The clinicopathological factors, surgical methods and Local recurrence, the use of Logrank test analysis of the above factors on the impact of disease-free survival. Results All patients had pathological diagnosis of benign breast lobular tumors in 29 cases, borderline breast lobular tumors in 11 cases, malignant breast lobular tumors in 8 cases, no case of axillary lymph node metastasis was found. The 39-year follow-up showed that the 1-year, 3-year and 5-year disease-free survival rates were 83.8%, 69.4% and 66.1% respectively, and the 5-year overall survival rate was 93.0%. Local recurrence in 10 cases, of which 6 cases of local recurrence after tumor resection. Patients with tumor resection and local recurrence relationship, the difference was statistically significant (P = 0.01). Conclusion Surgery is the main treatment for breast lobular tumors. The inappropriate choice of surgical procedure is related to local recurrence. It is suggested that surgical resection of breast lobectomy should be performed with partial excision, mastectomy or breast reconstruction, and mastectomy should be avoided. Axillary lymph node dissection.