307例女性乳腺髓样癌报告

Mortality Analysis of 307 Cases with Modullary Breast Carcinoma

本文总结了３０７例经治的中国女性乳腺髓样癌。根据Ｒｉｄｏｌｆｉ等制定的诊断标准（ｃａｎｃｅｒ，１９７７，４０：１３６５～１３８６），分为９２例（２９．９％）典型髓样癌和２１５例（７０．０％）非典型髓样癌。结果表明９２例典型髓样癌和２１５例非典型髓样癌的１０年生存率分别为８４．８％（７８／９２）和７３．０％（１５７／２１５）。腋窝淋巴结的转移情况被认为是影响预后的重要因素，在腋窝淋巴结无转移组５６例典型髓样癌和１１４例非典型髓样癌的１０年生存率分别为９２．９％（５２／５６）和８６．０％（９８／１１４），而在腋窝淋巴结有转移时分别为７２．２％（２６／３６）和４９．５％（５０／１０１）。乳腺髓样癌具有良好的组织学特征和预后效果，特别是腋窝淋巴结阴性的典型髓样癌的预后效果最佳。

307 female patients with medullary carinoma of breast are analysed retrospectively. According to the criteria of Ridolfi et al 92 patients(29.9%)suffered from typical medullary carcinoma and 215 patients(70.0%)from atypical one.All patients underwent radical mastectomy with chemotherapy or radical mastectomy with chemotherapy and irradiation.The results showed that 10 years surival rate was 84.8% and 73.0% in patients with typical medullary carcinoma(78/92 cases)and patients with atypical medullary carcinoma respectively(157/215 cases).The microscopical auxillary lymph nodes status were considered to be the most important prognostic factor.In the group without mestastases(PNO)52 patients survived 10yesrs in 56 cases(92.9%)with typical carcinoma and 98 patients in 114 caces with atypical carcinoma(86.6%).However,in metastases positive(PN+)group they were 72.2%(26/36 cases)and 49.6%(50/101cases)only.Medullary carcinoma of the berast had a favorable histological characteristics and prognostic results.Especially,the prognosis of typical medullary carcinoma for PNO patients was much better than the atypical medullary carcinoma.