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目的探讨原发性双侧乳腺癌的超声特征及病理表现。方法收集2001年1月-2009年4月24例经手术病理及临床证实的原发性双侧乳腺癌患者资料。其中双侧同时性乳腺癌患者9例,年龄41~60岁,平均47.3岁;双侧异时性乳腺癌患者15例,首癌诊断年龄33~61岁,平均43.2岁,第二癌诊断年龄38~69岁,平均49.1岁,首癌与第二癌间隔时间3~8年,平均5.9年。对其超声和病理资料进行回顾性分析。结果原发性双侧乳腺癌的分布部位以外上象限居多,多数肿瘤的边界不清楚,形态不规则,内部回声不均匀;而纵横径比值、后方回声衰减和钙化灶见于部分肿瘤;Adler血流分级以较高的Ⅱ和Ⅲ级为主。病理检查结果显示双侧同时性乳腺癌中浸润性导管癌17个,浸润性小叶癌1个;双侧异时性乳腺癌中浸润性导管癌27个,导管内癌2个,髓样癌1个。结论多数原发性双侧乳腺癌具有典型乳腺癌的超声征象,乳腺癌术后随访应建立在超声等影像学的基础上,超声导向下的穿刺活体组织检查可以提高双侧乳腺癌的检出率。
Objective To investigate the ultrasound features and pathological features of primary bilateral breast cancer. Methods The data of 24 patients with primary bilateral breast cancer confirmed by pathology and clinics from January 2001 to April 2009 were collected. Including bilateral simultaneous breast cancer in 9 patients, aged 41 to 60 years old, with an average of 47.3 years; 15 cases of bilateral synchronous breast cancer, the first diagnosis of cancer aged 33 to 61 years, mean 43.2 years, the second diagnosis of cancer age 38 to 69 years old, average 49.1 years old, first cancer and second cancer interval of 3 to 8 years, an average of 5.9 years. The ultrasound and pathological data were retrospectively analyzed. Results Primary bilateral breast cancer was mostly located outside the upper quadrant. Most of the tumors had unclear boundary, irregular shape and uneven internal echo. The aspect ratio, posterior echo attenuation and calcification were found in some tumors. Adler blood flow Grading with higher Ⅱ and Ⅲ grade based. Pathological examination showed that there were 17 invasive ductal carcinomas and 1 infiltrating lobular carcinoma in bilateral simultaneous breast cancer, 27 invasive ductal carcinomas in bilateral synchronous breast cancer, 2 intraductal carcinomas and 1 medullary carcinoma A Conclusion Most of the primary bilateral breast cancers have the typical signs of breast cancer. Postoperative follow-up of breast cancer should be based on ultrasound imaging and biopsy-guided biopsy to improve the detection of bilateral breast cancer rate.