乳腺癌前病变与早期乳腺癌的探讨

The Correlation between Precancerous Lesions of the Breast and the Early-stage Breast Cancer

目的:从临床角度探讨乳腺癌前病变及其与早期乳腺癌的关系。方法:回顾性分析自1992年1月至2004年12月收治的以乳头溢液为主诉和乳腺局限性腺体增厚以及近5年来收治的乳腺局限性腺体增厚恶变患者的临床病理资料。结果:共收治乳头溢液(不伴肿物)患者252例,其中乳头状瘤病或导管上皮增生活跃31例,占12.3%,乳腺癌22例,占8.7%,3例乳头状瘤病3年后发生同侧乳腺癌;乳腺局限性腺体增厚患者192例,其中乳头状瘤病或导管上皮增生活跃23例,占12.0%,乳腺癌19例,占9.9%;乳腺局限性腺体增厚终显典型恶性征者52例,占同期乳腺癌患者的5.2%(52/1008)。结论:乳头溢液(特别是血性乳头溢液)和乳腺局限性腺体增厚是癌前病变和早期乳腺癌的重要体征。

Objective： To explore the correlation between the precancerous lesions of the breast and the early-stage breast cancer by a clinical point of view. Methods： The clinicopathological data were analyzed retrospectively for the pationts with nipple discharge and local thickening of glandular organ of the breast treated during January 1992 to December 2004 and for those with canceration of local thickening of glandular organ of the breast of nipple discharge （without lumps）, 31 were 12.3%, 22 breast cancer with a percentage of treated in recent 5 years. Results： Among the 252 cases papillomatosis and epithelial hyperplasia, accounting for 8.7% and 3 papillomatosis developed into homonymous breast cancer 3 years later. Among 192 cases with local thickening of glandular organ of the breast, 23 were papillomatosis and epithelial hyperplasia （12%） and 19 were breast cancer （9.9%）. A total of 52 cases were canceration of local thickening of glandular organ of the breast, accounting for 5.16% （52/1008） that the breast cancer treated at the same period. Conclusion： Nipple discharge and local thickening of glandular organ of the breast can not only be the precancerous lesions but also the important physical signs of the early-stage breast cancer.