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早期乳腺癌62例分析(1)
http://www.100md.com 2008年8月5日 《中国实用医药》 2008年第22期
     【摘要】 目的探讨早期乳腺癌的临床特点及诊断方法,为提高早期乳腺癌的诊断率提供参考依据。 方法回顾性分析2003年1月至2006年12月收治的62例早期乳腺癌的临床资料。结果62例患者中乳腺局限性增厚37例(59.7%),可触及结节者23例(37.1%);有乳腺增生病史伴增生症状加重者45例(72.6%)。钼靶X线钙化25例(40%),肿块结节影10例(16.1%)。50例(80.6%)超声检出边界不规则低回声结节,78%的结节内或周围可测到血流信号。46例通过Mammotone微创乳房肿块活检系统进行取材活检获得诊断,16例由超声或钼靶定位后手术活检确诊。结论高危年龄妇女乳腺增生伴症状加重,乳腺局限性增厚是早期乳腺癌的重要表现;彩色多普勒超声及钼靶X线检查对早期乳腺癌有一定的诊断价值;Mammotone微创活检诊断系统在早期乳腺癌诊断中具有很高的应用价值;可提高早期乳腺癌的诊断率。

    【关键词】早期乳腺癌;局限性增厚;Mammotone微创活检系统

    Reporting of early stage breast cancer clinicalcharacteristic and diagnostic methods
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    LI Qing,HU Qiang.DepartmentofGeneral Surgery,the Second PeopleHospital ofZhumadian,Zhumadian 463000,China

    【Abstract】 ObjectiveIn order to provide the reference basis improving the diagnostic rate,this article analyzed the clinical characteristic and diagnostic methods of early stage breast cancer. MethodsThe clinical data of 62 early stage breast cancer inpatients from Jan 2003 to Dec 2006 were surveyed retrospectively. ResultsOf the 62 patients,37(59.7%) cases appeared to bethickening locally on mammary glands,another 23 cases (37.1%) can befeltnodules whenpalpation.Besides,symptoms of 45(72.6%) patients with mammary glands hyperplasia became heavier not long before visiting.25(40%) cases presented calcification merely on mammog-
, 百拇医药
    raphy,mass reflection was detected with mammography in 10(16.1%) patients.Ultrasound preoperative examination showed irregularity boundary low level-echo tubercles in 50(80.6%)patients,and blood flow signal was detected within or around the tubercles in 78%patients.46 patients was diagnosed through the Mammotone mini-invasive breast biopsy technology.And another 16 patients reached the final diagnosis with operational biopsy after ultrasound allocation. ConclusionSymptoms increasing of mammary glands hyperplasia or developing local thickening of mammary glands in high risk aged women always suggest the possibility of early stage breast cancer.Forthe early stage breast cancer patient,Color Doppler Ultrasound and mammography were provided with the diagnostic value.For diagnosing the early stage breast cancer,the Mammotone mini-invasive breast biopsy technology has very high application value and can raise the diagnostic rate.
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    【Key words】Early stage breast cancer;Local thickening; Mammotone mini-invasive biopsy technology

    2003年1月至2006年12月共收治乳腺癌206例,其中病理组织学诊断为早期乳腺癌62例,对62例早期乳腺癌的临床资料进行分析,总结其临床特点及诊断方法,现报告如下。

    1 临床资料

    1.1 一般资料 62例早期乳腺癌患者均为女性。年龄27~78岁,平均49岁。已婚并有生育史者57例,未婚5例;绝经前49例,绝经后13例;肿瘤位于左侧39例,右侧23例;外上象限30例,外下象限18例,内上象限14例。有乳腺癌家族史9例。

    1.2 临床表现 12例有1~3年乳腺增生史且近期症状加重,33例有3年以上乳腺增生史且近期症状加重;其中37例可触及病变区乳腺不均质局限性增厚。62例患者中可触及结节者23例(直径1.0 cm 14例),39例的结节内或周围可测到血流信号;其中查体可触及结节者23例,查体仅表现为乳腺局限性增厚27例,另有乳腺囊性变5例,单纯增生改变7例。

    1.4 钼靶X线所见 全部患者均有增生改变。单纯增生改变21例,25例伴有单纯钙化灶,大片簇状分布;伴有不规则致密影6例;肿块结节影10例。

    1.5 病理资料 按照2003年美国癌症联合会(AJCC)修订的TNM分期法分期,术前T1 N0 M0 56例,T2 N0 M0 6例。经皮穿刺活检获得诊断46例,其余16例由超声或钼靶定位后手术活检确认。其中导管内癌26例,早期浸润性导管癌34例,浸润性小叶癌2例,ER阳性46例,阴性16例。6例术前触及肿大淋巴结,术后病理证实淋巴结无癌转移。, 百拇医药(李 卿 胡 强)
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