乳腺分叶状肿瘤14例的诊断和治疗

The diagnosis and treatment of phyllodes tumor of the breast: report of 14 cases

目的 探讨乳腺分叶状肿瘤的临床病理特点、治疗原则和影响预后的因素。方法回顾 1993年 6月至 2 0 0 1年 2月收治的 14例乳腺分叶状肿瘤患者的临床资料。结果 14例患者平均年龄 35岁 ,按WHO分类标准 ,其中良性 5例 ,交界性 5例 ,恶性 4例。 7例行局部切除术 ,4例行乳腺单纯切除术 ,3例行乳腺癌改良根治术。随访 11例 ,平均随访时间 19个月 (6～ 96个月 ) ,1例行乳腺癌改良根治术后 2年死于远处转移 ,3例行局部切除术后复发。结论 保证 1～ 2cm切缘的扩大局部切除术是治疗乳腺分叶状肿瘤的首选方案。

ObjectiveTo evaluate the potential prognostic factors, and to better define appropriate treatment strategies for patients with phyllodes tumor of the breast. MethodsFourteen patients treated primarily for phyllodes tumor of the breast were reviewed retrospectively.Results The median age was 35 years. According to the histologic criteria of WHO, there were 5 benign cases(36%), 5 borderline cases(36%), and 4 malignant cases(29%). Seven patients underwent local excision, 4 cases did simple mastectomy, and 3 cases did modified radical mastectomy. Follow-up was obtained for 11 cases, with an average of 19 months. One patient died from metastasis 2 years after a modified radical mastectomy. Three patients treated by local excision presented local recurrence.Conclusion The outcome of phyllodes tumor appears to be determined by the biology of the tumor rather than by treatment modality. A wide local excision, with an adequate margin of normal breast tissue is the preferred initial therapy for phyllodes tumor of the breast.