851例可手术乳腺癌临床特点分析

The Analysis of Clinical Characteristics of 851 Cases of Resectable Breast Cancer

目的通过分析乳腺癌临床特点,进一步提高其诊治水平。方法回顾性分析我院851例手术治疗的乳腺癌患者的临床资料。结果 851例乳腺癌患者平均年龄(54.3±11.4)岁。50～59岁为发病的高峰年龄段,占37.1%。全数字化乳腺X线摄影诊断阳性率90.4%(709/784),乳腺B超检查的诊断阳性率为82.6%(630/763),两者联合检查可以提高乳腺癌的诊断阳性率,可达92.2%。浸润性导管癌是最常见的病理类型(80.9%)。早期乳腺癌患者占58.9%(501/851);晚期患者占19.7%(168/851)。雌激素受体(ER)和(或)孕激素受体(PR)阳性者占58.1%(482/829);表皮生长因子受体-2(HER-2)阳性者占20.7%(171/825);ER、PR、HER-2均为阴性者占30.9%(255/825)。改良根治术是主要的手术方式,占91.5%(787/860);行保乳术者仅占4.4%(38/860)。行新辅助化疗者占7.1%(60/851);行术后辅助化疗者占89.3%(760/851)。482例进行内分泌治疗。行保乳术的患者均予以放疗。结论全数字化乳腺X线摄影是早期乳腺癌诊断的首选方法,结合B超能进一步提高诊断阳性率。手术、新辅助化疗、术后化疗、内分泌治疗和放疗等综合治疗方案能提高乳腺癌患者的生存率和降低死亡率。

Objective To improve the diagnosis and treatment levels of breast cancer by analyzing the clinical characteristics of the breast cancer. Methods The clinical characteristics of 851 cases of respectable breast cancer were analyzed retrospectively. Results The mean age of 851 cases was （54.3 ± 11.4） years. The high risk age of breast cancer was 50-59 years （37. 1% ）. The positive rate of full-field digital mammography was 90. 4% （709/784） ,the positive rate of B ultrasound was 82.6% （630/763）, the positive rate of joint inspection was 92.2%. The most common pathology subtype was infiltrating ductal carcinoma （ 80.9% ）. The early breast cancer accounted for 58.9% （501/851）, and the advanced breast cancer accounted for 19.7% （ 168/851 ）. Both or either positive of estrogen receptor （ER） and progestin receptor （PR） accounted for 58.1% （482/829） ; human epider- mal growth factor receptor 2 （HER-2） positive accounted for 20.7% （171/825） ; ER, PR, HER-2 negative ac- counted for 30.9% （255/825）. 91.5% （787/860） received the modified radical mastectomy; 4.4% （38/860） received the breast conservative surgery. 7. 1% （60/851） received the preoperative neoadjuvant chemotherapy; 89.3% （760/851） received the postoperative adjuvant chemotherapy. The 482 cases received the endocrine thera- py. All the patients received the breast conservative surgery received the radiotherapy too. Conclnsion The full- field digital mammography is the first choice in the diagnosis of early breast cancer, full-field digital mammography combined with B ultrasound can improve the positive rate. The combined application of surgery,preoperative neoad- juvant chemotherapy, postoperative adjuvant chemotherapy, endocrine therapy, radiotherapy can improve the survival rate and induce the death rate of the breast cancer.