湿疹样乳腺癌85例临床分析

Clinical analysis of 85 patients with eczema-like breast cancer

目的探讨湿疹样乳腺癌的临床特点,诊治方法及预后因素,提高对湿疹样乳腺癌的认识。方法回顾性分析作者在韩国首尔峨山医院进修时收集的85例湿疹样乳腺癌患者的临床资料。结果女83例,男2例。乳腺有湿疹样表现79例(92.9%),伴乳腺肿块52例(61.2%),同侧腋窝淋巴结转移27例(占本组85例的31.8%及占伴乳腺肿块病例的51.9%),均为伴有乳腺肿块的病例。52例行乳癌改良根治术,30例行乳腺单纯切除术,3例行局部切除术。单纯乳头及乳晕湿疹样乳腺癌11例(12.9%),均为无乳腺肿块的病例,其余74例(87.1%)均合并其他类型的乳腺癌。本组5年生存率为82.1%,其中无乳腺肿块者5年生存率为93.9%,合并肿块者5年生存率为75.0%(P<0.05),无同侧腋窝淋巴结转移者5年率为96.6%,有转移者5年生存率为51.9%(P<0.01)。结论湿疹样乳腺癌有特殊的临床表现,但易误诊,病灶细胞学和病理学检查可以确诊,伴乳腺肿块者应选择乳癌改良根治术,无乳腺肿块者可选择乳腺单纯切除术,预后与乳腺肿块及同侧腋窝淋巴结转移密切相关。

Objective Investigate Eczema-like breast cancer on its clinical feature,diagnosis,treatment and prognostic factors,in order to improve the awareness of eczema-like breast cancer. Methods Retrospective analysis of the clinical data collected by author in Seoul Asan Hospital,which including 85 cases of eczema-like breast cancer. Results 83 female cases and 2 male cases. Galactophore had eczema-like symptom in 79 cases （92. 9% ） ,52 patients with breast lumps（ 61.2% ）, ipsilateral axillary lymph nodes metastasis in 27 patients （31.8% of 85 patients and 51.9% of which had breast lumps） ,every case had breast lumps. 52 cases did breast cancer modified radical mastectomy,30 cases did adenomammectomy,3 cases did partial mammectomy. Simple nipple and areola mammae eczema-like breast cancer in 11 cases （ 12.9% ） , none of which had breast lumps, and the remaining 74 cases（87. 1% ） were associated with other types of breast cancer. The 5-year survival rate was 82. 1% ,5-year survival rate of the cases which had no breast lumps was 93.9% ,5-year survival rate of the cases which had incorporative lumps was 75.0% （P 〈 0. 05 ） ,5-year survival rate of the cases which had no ipsilateral axillary lymph nodes metastasis was 96.6% , and 5-year survival rate of the cases which＇had ipsilateral axillary lymph node meatstasis was 51.9% （P 〈 0. 01 ）. Conclusion Eczema-like breast cancer has a special clinical symptom, but is misdiagnosed uslially, can be diagnosed with focus cytological and pathological examination. Breast cancer with breast lumps should be done modified radical mastectomy, breast cancer without breast lumps can be done adenomammectomy, the prognosis related to breast lumps and ipsilateral axillary lymph nodes metastasis.