副乳腺癌17例临床病理特征及预后分析

The clinical features and prognosis analysis of 17 cases of accessory breast cancer

目的:探讨副乳腺癌患者的临床病理特征、诊断、治疗及预后。方法:回顾性分析我院乳腺科2007年1月至2017年12月收治的17例副乳腺癌患者的临床病理资料、诊疗及预后情况,随机抽取同期85例乳腺癌患者对照分析。结果:17例副乳腺癌患者占同期15 500例乳腺癌的0. 11%,中位年龄48岁,绝经患者5例,7例有肿瘤家族史,6例行改良根治术,余下患者行保留乳房的腋下肿瘤扩大切除加腋窝淋巴结清扫术。组织学类型最常见为浸润性导管癌14例,其他类型3例。分子分型最常见为Luminal A 9例,Luminal B 2例,HER-2型2例,三阴型4例。病理分期最常见为III-IV期12例。副乳腺癌患者3年无病生存率(diseasefree survival,DFS)为27. 9%,明显低于常规乳腺癌3年DFS 70. 8%(P <0. 05),与腋窝淋巴结阳性的乳腺癌患者相比,无统计学差异。结论:副乳腺癌发病率低,发病部位隐匿,易出现漏诊和误诊,易出现淋巴结转移,预后较常规乳腺癌差。

Objective: To explore the clinicopathological characteristics,diagnosis,treatment and prognosis of accessory breast cancer. Methods: The clinical data were retrospectively analyzed for 17 patients with accessory breast cancer from January 2007 to December 2017,and 85 cases of breast cancer in the same period were randomly selected. Results: 17 cases of accessory breast cancer accounted for 0.11% of all 15 500 breast cancer cases during the same period.The median age was 48 years.5 cases were menopause.7 cases had the family history of tumor.6 cases were treated with Auchincloss mastectomy.The remaining patients underwent breast-conserving local wide excision of tumor plus axillary lymph node dissection.The most common histological type of accessory breast cancer was infiltrating ductal carcinoma for 14 patients.There were 3 cases of other types.The most common molecular type of accessory breast cancer was Luminal A for 9 patients,there were 2 cases of Luminal B,2 cases of HER-2,and 4 cases of TNBC.The most common pathological stages ware stage III and stage IV in 12 cases.The 3-year disease-free survival rate (DFS) of the patients with accessory breast cancer was 27.9%,significantly lower than that of breast cancer ( P <0.05).There was no statistical difference between breast cancer with axillary lymph nodes metastasis. Conclusion: The incidence of accessory breast cancer is low,and the location of the disease is hidden.The misdiagnose and the lymph node metastasis are easy to occur,and its prognosis is worse than that of breast cancer.