乳腺派杰氏病8例临床分析

A clinical analysis of 8 cases with breast Paget′s disease

目的:探讨乳腺癌派杰氏病(Paget′s病)的流行病学、临床病理特点和预后。方法:对经手术和病理证实的8例乳腺癌派杰氏病的临床资料进行回顾性分析。结果:乳腺Paget′s病以慢性乳头皮肤改变为主要特点,平均发病年龄53岁。单纯乳腺派杰氏病4例(50%),伴有浸润性癌1例(12.5%)。总的1年和3年生存率分别为100%和87.5%,远处转移率为12.5%;触及肿块和未及肿块患者1年和3年生存率分别为100%5、0%和100%、100%;以乳头病变与乳腺肿块为首发症状患者1年和3年生存率分别为100%、100%和100%、0%;单纯Paget′s病/或合并导管内原位癌患者与Paget′s病伴有浸润性导管癌者1年和3年生存率分别为100%、100%和100%、0%。结论:乳腺派杰氏病病变局限于乳头、无可触及肿块、非浸润性癌、早期诊断及以手术为主综合治疗的乳腺癌派杰氏病患者预后较佳。

Objective： To explore the epidemiological, clinicopathaloical characteristics and prognosis of paget＇s disease. Methods： The clinical data of 8 cases which were treated and confirmed paget＇s disease by biopsy were analyzed retrospectively. Results： The clinical features of the disease was slow change of eczematoid nipple. The mean age of patients was 53 years. There were 4 cases （50%） of simple paget＇s disease and 1 cases of breast cancer combined with paget＇s disease. The 1 and 3 year survival rate of whole group were 100% and 87.5% respectively, the rate of metastasis was 12.5% ; Among patients the 1 and 3 year survival rates of Paget＇s disease with a palpable mass and Paget＇s disease without a palpable mass were 100%, 50% and 100%, 100% respectively; The 1 and 3 year survival rates of patients with nipple change as the first symptom and patients with a palpable mass as the first symptom were 100%, 100% and 100%, 0% respectively; The 1 and 3 year survival rates of patients with simple paget＇s disease/or combined carcinoma in situ and patients combined with invasive ductal cancer were 100%, 100% and 100%, 0% respectively. Conclusions： In these patients whose disease is confined to the nipple, without palpable mass, non-invasive cancer, early diagnosed and received universal treatment have a better prognosis.