乳腺癌合并肺孤立性结节外科治疗的临床分析

Surgical treatment for solitary pulmonary nodule in breast cancer patients

为了探讨外科治疗在乳腺癌合并肺孤立性结节诊断及治疗中的作用,对13例乳腺癌根治术同期行肺孤立性结节手术切除的临床资料进行回顾性分析。结果:手术治疗的13例患者中,肺孤立性病灶的病理结果6例为原发性肺癌,5例为乳腺癌肺转移,2例为良性病变;手术方式:1998年以前患者采用小切口开胸手术(4例),之后的患者采用胸腔镜辅助小切口手术(9例)。术后并发症为皮下气肿和支气管胸膜瘘,无手术死亡。初步研究结果提示,乳腺癌合并的肺孤立性结节并不都是肺转移瘤,乳腺癌合并肺孤立性结节应该尽可能取得病理诊断,得到正确的治疗。

The objective of this study was to assess the role of surgery in the diagnosis and treatment of a solitary pulmonary nodule （SPN） in breast cancer patients. A series of 13 patients who underwent surgery for SPN in breast cancer between 1994 and 2007 were reviewed. RESULTS： Histology of SPN was primary lung cancer in 6 patients, pulmonary metastasis of breast cancer in 5, and benign condition in 2. Surgical diagnosis was obtained by open procedure before 1998 （4 cases）, and by video-assisted thoracoscopic surgery （VATS） after 1998 （9 cases）. There were no death during perioperative period, and the common complications were subcutaneous emphysema and bronchopleural fistula. In conclusion, as pulmonary nodules that appear in breast cancer patients are not always pulmonary metastases, the pathologic diagnosis should he confirmed. The patients with SPN in breast cancer should deserve confirmation of pathological diagnosis and appropriate surgical treatment.