青年期女性乳腺癌临床病理分析

Clinical and Pathologic Analysis of Breast Cancer in Younger Women

目的 探讨青年期女性乳腺癌的临床和病理学特点并分析这些因素对生存预后的影响。方法 回顾性总结1994～2000年间81例青年期女性乳腺癌。分析肿瘤大小、腋淋巴结情况、TNM分期与生存率的关系，并随机抽取同期非青年期女性乳腺癌90例作为对照。结果 青年期女性乳腺癌发病率占同期乳腺癌人群的11．7％，五年总生存率56．9％，而对照组为77．8％（P〈0．05）。肿瘤〉3cm，五年生存率47．9％；肿瘤≤3cm，五年生存率75．0％（P〈0．05）。腋淋巴结转移数量≥4枚，5年内死亡率高达70．4％。Ⅱb期以早的病人五年生存率68．6％，Ⅲa期以后的病人五年生存率28．6％。病理类型以单纯癌多见，浸润性导管癌次之。结论 青年期乳腺癌与非青年期女性乳腺癌相比显示出更强的侵袭性且预后不佳。肿瘤大小、腋淋巴结转移数量与生存率负相关。Ⅱb期以早病人显示预后明显优于Ⅲa期以后病人。

Objective To explore the clinical and pathologic characteristics of breast cancer in women less than 35 years of age and the influencing factors on survival. Methods The clinical data from 81 younger women aged less than or equal to 35 years admitted in our hospital from 1994 to 2000 were analyzed retrospectively according to the relationship betwean the survival rate and the tumor size, axillary lymph nodes, and UICC - TNM staging system. Another 90 cases above 35 years old were served as control. Results Breast cancer in younger women accounted for approximately 11. 7% of all breast cancer cases. Overall 5 - year survival rate was 56.9 %, whereas the control group was 77. 8 % （ P〈 0.05）. When tumor was over 3cm , the 5 - year survival rate was 47.9 % ; whereas the tumor size was less than or equal to 3cm, the 5 - year survival rate was 75.0 % （P〈0.05）. If number of axillary positive node was greater than or equal to 4, the 5 - year mortality was as high as ？0.4 %. The 5 year survival rate was 68.6% in patients with tumor stage earlier than Ⅱ b, but only 28.6 % in cases later than Ilia. Conclusions Younger women with breast cancer often demonstrate more invasive characteristics and have relatively poor prognosis. The survival rate is negatively related with tumor size and number of infiltrated positive axillary lymph nodes. Breast cancer patients earlier than stage Ⅱ b have much better prognosis than patients later than stage Ⅲa.