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目的探讨乳腺分叶状肿瘤这一少见疾病的诊治要领。方法收集我院1990年至2004年病理诊断为叶状囊肉瘤或分叶状肿瘤17例,并对其临床病理特征进行分析。结果发病年龄为27~62岁(平均43岁)。左右侧比10∶7;11例位于乳头下、6例位于乳头旁外上象限,具有近乳头之特点。12例良性,2例交界性,3例恶性临床表现为无痛性包块,较长时间(1年~7年余)后出现包块增大、乳腺外形改变,1例伴腋窝淋巴结肿大。14例行肿块单纯切除术,其中有3例术后半年复发、1例术后半年复发(单纯切除)及再次术后3个月复发而行单纯乳房切除术(包括腺体、胸大肌膜及皮肤)随访3年无复发,复发率达28·57%(4/14);复发中良恶性各2例,交界性2例尚未复发。结论分叶状肿瘤的病理诊断与临床表现及预后往往不符,良恶性均可能复发,复发率恶性者较高,良性者较低;多方面综合分析,选择合理的手术方式,对复发者行单纯乳房切除术、恶性及腋窝淋巴结肿大者行根治术即可。
Objective To investigate the diagnosis and treatment of breast cancer, a rare disease. Methods Totally 17 cases of phyllodes cystosarcoma or lobulated tumor were collected from 1990 to 2004 in our hospital. The clinical and pathological features were analyzed. Results The onset age ranged from 27 to 62 years (mean, 43 years). Left and right than the 10:7; 11 cases located in the nipple, 6 cases located in the upper quadrant outside the quadrant, with the characteristics of near the nipple. 12 cases of benign, 2 cases of borderline, 3 cases of malignant clinical manifestations of painless mass, a long time (1 year to more than 7 years) increased mass, changes in breast shape, 1 case with axillary lymph nodes . 14 cases of simple excision of the tumor, including 3 cases of recurrence after six months, 1 case of recurrence after 6 months (simple excision) and 3 months after the recurrence of simple mastectomy (including the gland, pectoralis major membrane And skin) were followed up for 3 years. The recurrence rate was 28.57% (4/14). There were 2 cases of benign and malignant recurrence and 2 cases of borderline relapse. Conclusions The pathological diagnosis of lobulated tumors is not consistent with clinical manifestations and prognosis. Both benign and malignant tumors may relapse, with high recurrence rate and low benign degree. In many aspects, a comprehensive analysis is conducted to select a reasonable surgical approach to recurrent simple Mastectomy, malignant and axillary lymph nodes can be radical surgery.