乳腺放射状瘢痕31例临床分析

Clinical analysis of 31 patients with breast radial scar

目的分析乳腺放射状瘢痕(radial scar,RS)的临床病理特点和处理方法。方法回顾性分析2003年7月至2008年6月天津医科大学附属肿瘤医院收治的31例乳腺RS患者的临床病理资料。结果RS患者的中位年龄为48岁(23～75岁),其中12例因乳腺肿物就诊。31例患者中6.5%(2/31)为单纯乳腺RS,45.2%(14/31)伴有乳腺良性病变,48.4%(15/31)伴有乳腺癌。16例单纯或伴良性病变的乳腺RS患者中,行超声检查者11例,行X线检查者14例;临床初诊误诊率为10/16,超声诊断误诊率为5/11,X线诊断误诊率为9/14,冰冻病理诊断符合率为16/16。15例RS伴乳腺癌患者的各种辅助检查均诊断为乳腺癌。所有RS患者均接受手术治疗,术后随访6～66个月(中位随访34个月),患者均健在,无局部复发,亦无继发乳腺恶性肿瘤。结论乳腺RS多伴其他乳腺病变,与乳腺癌的关系不明确,术前辅助检查易与乳腺癌混淆。手术局部切除是安全有效的诊治措施。

Objective To study the clinical and pathological features and treatment methods of breast radial scar （RS）. Methods The clinical and pathological data of 31 patients of breast RS treated in Tianjin Cancer Hospital between June 2003 and July 2008 were retrospectively analyzed. Results The median age of the RS patients was 48 years （range, 23-75）. Twelve patients were admitted for breast mass. Of the 31 patients, only 2 （6.5%） had simple RS; 14 （45.2%） had RS with benign lesions, and 15 （48.4%） had RS with breast cancer. Among the 16 patients of RS and RS with benign lesions, the misdiagnosis rate was 10/16 in clinical practice （ 5/11 by ultrasound and 9/14 by mammography） ; the detection rate was 16/16 by frozen pathology. The 15 patients of RS with breast cancer were all diagnosed as breast cancer by all auxiliary examinations. All patients received surgery. After a median follow-up time of 34 months （6 to 66 months） after surgery, no patients had recurrence or secondary tumors and all patients were survived without disease at the end of the follow-up period. Conclusion Breast RS is usually accompanied with other breast diseases. Preoperative auxiliary examinations are not accurate or reliable, which often provide misdiagnosis of breast cancer. Local excision is a safe and effective method of diagnosis and treatment.