分泌型乳腺癌39例临床分析

Clinical analysis of secretory breast cancer： 39 cases

目的乳腺分泌型癌是一种特殊类型乳腺癌，目前研究较少，多为个案报道，本研究旨在探讨分泌型乳腺癌的临床病理及预后特点。方法回顾性分析1986年1月至2012年3月天津肿瘤医院收治的经病理确诊为分泌型乳腺癌39例的临床资料，中位随访时间73（2—221）个月，观察其临床病理特点及生存状况。结果本组男2例，女37例；中位年龄52（11～75）岁；临床表现以乳房肿块为主，30例（76．9％）肿瘤为T2期（2cm〈T≤5cm），TNM分期29例（74．4％）Ⅱ期，24例（61．5％）无淋巴结转移；雌激素受体（estrogenreceptor，ER）阳性表达17例（54．8％），孕激素受体（progesteronereceptor，PR）阳性表达11例（37．9％），三阴性乳腺癌9例（42．9％）；随访2例（5．1％）患者死亡，2例20岁以下青少年患者未发现复发转移。结论分泌型乳腺癌可见于任何年龄，男女均可发病，肿瘤以早期为主，激素受体阳性表达率低，三阴性乳腺癌多见，总体预后较好，但有远处转移风险，应长期随访观察，青少年患者预后优于成人。

Objective Secretory breast cancer is a rare and specific subtype of breast carcinoma, and most reports on it are case report. This study is to explore the clinicopathological and prognosis characteristics of secretory breast cancer in Chinese. Methods The clinicopathological data of 39 patients of secretory breast cancer diagnosed from Jan. 1986 to Mar. 2012 at Tianjin Medical University Cancer Hospital were retrospectively analyzed. The postoperative follow-up was 2 to 221 months, with a median follow-up of 73 months. The clinico- pathological features and survival condition were observed. Results There were 2 male and 37 female patients, ranging from 11 to 75 years old, with the median age of 52 years old. The main clinical manifestation of secretory breast cancer was breast mass. 30 patients（76. 9% ）were in T2 breast cancer（2 cm 〈 T~〈5 era）, 29 patients （74. 4% ）were in clinical stage II according to TNM stage, and 24 patients（61.5% ）had no lymph node metasta- sis. 17 patients （54. 8 % ）bad positive expression of estrogen receptor（ ER）, 11 patients （37.9 % ）had positive ex- pression of progesterone receptor（PR）, and 9 patients （42. 9% ）were triple negative breast cancer. During the follow-up, 2 patients （5.1% ）died from the disease, and 2 patients under than 20 had no recurrence or metasta- sis. Conclusions Secretory breast cancer occurs in both sexes with a wide age range, mostly in an early clinical stage. The positive expression rate of hormone receptor is low. The proportion of triple negative breast cancer is high. The overall prognosis of patients with secretory breast cancer is good. Because of the risk of metastasis, pa- tients should be followed up for a long time. It seems that juvenile patients have a better prognosis.