乳腺实性肿块及早期外科干预的临床意义

Approach to the early surgical treatment of breast solid lumps

目的:分析临床检查未发现腋淋巴结肿大、乳头及乳房皮肤无异常、肿块小于3cm的乳腺实性肿块术后病理情况,探讨手术干预治疗对于早期发现和预防乳腺癌的作用。方法:对352例临床检查发现乳腺肿块,经B超证实为实性占位的患者行肿块切除活检。结果:病理报告良性肿块占96%,恶性肿瘤占4%,依次排列为:纤维腺瘤68.2%,乳汁瘤22.7%,乳腺癌4%,乳腺增生3.4%,其他良性肿瘤1.7%。纤维腺瘤主要分布在18～30岁青年女性,乳腺癌患者常有多年乳腺增生史或家族肿瘤病史。结论:乳腺肿块主要由良性病变构成,部分可能是一种癌前病变或早期癌肿,手术干预可以起到预防增生组织恶变及早期发现乳腺癌的作用。

Objective： To analyze the postoperative pathologic conditions of patients clinically found no axillary lymph node enlargement, no nipples and breast skin lession, and the breast solid mass is less than 3 cm so as to study the operative intervention treatment for early detection and prevention of breast cancer. Methods： 352 patients, from June 2005 to August 2009, were found with breast mass after being clinically examined. Those confirmed by B-ultra- sonography with solid masses were resected and inspected pathologically. Results： The pathological reports showed that 96% of the patients were with benign lumps and only 4% were with malignant tumors. The sequence of the find- ings were： fibroadenoma （68. 2%）, breast tumors （22. 7%）, breast cancer （4%）, ammary gland hyperplasia （3. 4 %）, and other benign tumors （1.7%）. Fiber adenoma was mainly distributed in the young female between the age of 18 to 30, and patients with breast cancer often had long medical history of mammary gland hyperplasia or family medical history of tumor. Conclusions： Breast lumps are mainly composed of benign lesions, and part of which are probably a premalignant lesion or early cancer, so surgical intervention can play an important role in preventing am- mary gland hyperplasia, deterioration of the tissues and early detecting breast cancer.