乳腺髓样癌的临床病理特点及治疗
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黄林平 E-mail:hlpsurg@sina.com

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Clinicopathologic features and treatment of medullary carcinoma of the breast
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    摘要:

    目的:探讨乳腺髓样癌的临床病理特点、诊治和预后。 方法:回顾性分析7年间收治的28例乳腺髓样癌的临床资料。全组进行手术和辅助化疗(环磷酰胺+阿霉素、紫杉醇+阿霉素)。5例内分泌治疗, 8例进行放射性治疗。 结果:28例乳腺髓样癌占同期治疗956例女性乳腺癌的2.9%; 年龄28~96(50.68 ± 12.63)岁; 肿瘤大小1~5 cm; 腋淋巴结阳性率47.6%; 肿瘤淋巴细胞浸润率100%。免疫组化检测雌激素受体(ER), 孕激素受体(PR), HER-2 / neu, p53的阳性率分别为35.7%, 32%, 32%, 67.9%。术后中位随访时间为42个月(1个月至6年), 总生存率为100%。 结论:乳腺髓样癌的预后较好。选择合理的外科手术及辅助化疗可取得较满意的效果。分子生物学指标在乳腺髓样癌治疗和预后的作用应该受到足够重视。

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    Objective:To explore the clinical characteristics, pathology, prognosis and proper treatment of medullary carcinoma of the breast(MBC). Methods:Retrospective analysis was carried out on the clinical data of 28 patients with MBC who admitted to our hospital from January 2004 to December 2010. Results:The incidence of MBC accounted for 2.9% of the breast cancer patients admitted to our hospital during the same period. The mean age was(50.68±12.63)years. The tumor size was 1-5 cm and axillary lymph node involvement was 47.6%. The overexpression of estrogen receptor(ER), progesterone receptor(PR), HER-2 / neu and p53 was 35.7%, 32%, 32%and 67.9%, respectively. All patients underwent operation and polychemotherapy(cyclophosphamide +Adriamycin, Paclitaxel+Adriamycin); endocrine therapy was applied in five patients, and three cases received postoperative irradiation. All the patients were followed up from 1 month to 6 years, and the overall survival rate was 100%. Conclusions:MBC is an invasiveless histological type of breast carcinoma with good prognosis. Proper surgical and adjuvant therapy is important to improve the survival and quality of life. Attension should be paid to investigation of MBC associated antigens to provide new ideas for its treatment.

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杨猛, 李忻, 庞春红, 黄林平.乳腺髓样癌的临床病理特点及治疗[J].中国普通外科杂志,2011,20(5):471-473.
DOI:10.7659/j. issn.1005-6947.2011.05.011

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  • 收稿日期:2011-01-08
  • 最后修改日期:2011-04-21
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  • 在线发布日期: 2011-05-15