隐匿性乳腺癌的诊断与治疗

Diagnosis and Treatment of Occult Breast Cancer

目的探讨隐匿性乳腺癌的临床特点及诊治方案。方法对7例隐匿性乳腺癌患者的临床资料进行回顾性分析。结果 7例患者中,5例找到乳腺癌原发灶,并行乳腺癌改良根治术,3例未出现局部复发或远处转移,2例出现远处转移;2例行保乳术患者无局部复发或转移。结论对有腋窝淋巴结转移腺癌无明显原发灶的患者,应高度警惕隐匿性乳腺癌;治疗应采用乳腺癌改良根治术或保乳术及腋窝淋巴结清扫,并行全乳腺及区域淋巴结引流区放疗、化疗、内分泌治疗和可能的靶向治疗。

Objective To investigate the clinical characteristics,diagnosis and treatment of occult breast cancer. Methods The data of 7 patients with occult breast cancer were retrospectively analyzed. Results Primary tumors were detected in 5 of the 7 patients,3 of the 5 patients treated by modified radical mastectomy for breast cancer sur-vived without local recurrence or distant metastases,2 patients occurred distant metastases;2 patients were treated by breast conserving surgery,all survived without diseases. Conclusion Occult breast cancer should be considered in female patients with metastatic adenocarcinoma of the axillary lymph nodes and without obvious primary cancer;treatment of the occult breast cancer could be modified radical mastectomy for breast cancer,breast conserving sur-gery and axillary lymph nodes dissection,followed by radiotherapy to the full-breast and drainage areas of regional lymph nodes ,and chemotherapy ,endocrine therapy and possibly targeted therapy.