乳腺叶状肿瘤的影像学诊断与手术方式分析

Summarize the experience of diagnoses and treatments in 23 cases of breast phyllodes tumor

目的分析乳腺叶状肿瘤的临床表现及病理特点,探讨乳腺叶状肿瘤的诊断及治疗方法.方法：回顾分析我科2005年1月至2015年6月期间诊治的47例乳腺叶状肿瘤患者的临床资料.结果：术前超声诊断符合率为61.7%,较钼靶的诊断符合率（33.3%）要高,穿刺病理多提示为腺纤维瘤,术中冰冻病理有13例需待常规石蜡病理,良性行单纯肿物切除7例,扩大切除术25例,单纯乳房切除术1例,恶性1例行改良根治术,交界性13例,9例行扩大切除术,4例行单纯乳房切除术.结论：术前穿刺病理必需与临床表现相结合,通过术中冰冻病理明确手术方式,扩大肿物切除术仍是良性叶状肿瘤的标准术式,但交界性及恶性的叶状肿物均需要行单纯乳房切除术.

Objective：Analysed the clinical manifestations and Pathological characteristics of the breast phyllodes tumor , to investigate the diagnoses and treatments of cystosarcoma phylloides of breast. Methods： Retrospective analysis the clinical data of 47 cases cystosarcoma phylloides of breast between January 2005and June 2015. Result： the coincidence of echogram diagnoses were 61.7%,highter than the coincidence of molybdenum target which were 33.3%;almost all pathological of puncture were adenofibroma, 13 cases of Intraoperative frozen section need to be confirm by Conventional paraffin pathology; 7 cases of benign tumor performed by simple tumor excision,25 cases were performed by extended resection,1 case was performed by simple mastectomy.1 case was malignant performed by modified radical mastectomy;9 cases were performed by extended resection and 4 case was preformed by simple matectomy in 13 cases of borderline tumor. Conclusion：dignoses of pathological by puncture must be link to clinical manifestations; Clear operation mode by Intraoperative frozen section; Standard operation of benign tumor was extended resection, borderline tumor and malignant must be preformed by simple mastectomy.