摘要
目的:探讨隐匿性乳腺癌的临床特点及诊治方法。方法:对17例隐匿性乳腺癌患者的临床资料及疗效进行回顾性分析。结果:17例超声检查中5例发现可疑病灶。7例接受乳腺强化MRI检查者4例发现可疑病灶。同时接受的PET-CT检查者仅1例发现可疑病灶。术后13例患者中10例找到乳腺癌原发灶(3～9 mm),随访1～7年,1例仅行腋窝淋巴结清除的患者于术后9个月超声检查时发现乳腺原发病灶,病灶直径11 mm,由于患者接受过全乳放疗,因此行乳腺单纯切除,术后未再行化疗,于二次手术后13个月出现肝转移,7个月后死亡,1例术后4年死于脑转移。结论:隐匿性乳腺癌作为一种特殊类型类型的乳腺癌在诊断上有其特殊性。寻找原发灶仍是诊断上的难点。相比较乳腺强化MRI有一定的优势。PET-CT与MRI相比并未显示明确的优越性。对于未发现原发灶的患者,手术方式仍以改良根治术为佳。虽然隐匿性乳腺癌预后较好,还应当依据NCCN指南对其进行以手术为主的综合治疗。
Objective： To explore the method of clinical features,diagnosis and treatment of occult breast cancer.Methods： The treatment effectiveness of 17 occult breast cancer patients data were analyzed retrospectively.Results： There were 5 suspicious patients in 17 who have received ultrasound examination,4 suspicious patients in 7 who have received enhanced MRI of breast examination.Only 1 suspicious case in the patients who accepted PET-CT at the same time.Postoperatively 10 in 13 patients found breast cancer original nidus（3-9mm）.During 7 years follow-up,9 months later,1 patient who only received axillary lymph nodes dissection found the original nidus which diameter was 11mm,when receive the B-ultrasound examination.Because the patient had received radiotherapy,she only received mastectomy without chemotherapy.13 months later,she found liver metastasis,7 months later she died.1 patient was died of brain metastasis.Conclusion： As special type,occult breast cancer had the characteristics in the diagnosis.Looking for primary tumors was still difficult.Enhanced MRI has certain advantages in diagnose.PET-CT did not appear certain advantages compared with the MRI.For those who could not be found primary tumors,the better surgy therapy is modified radical mastectomy.Although occult breast cancer prognosis is better,its treatment should base on the NCCN guidelines-advances in multimodality therapy of breast cancer.
出处
《中国现代普通外科进展》
CAS
2012年第11期867-872,共6页
Chinese Journal of Current Advances in General Surgery
