多灶性多中心性乳腺癌的临床病理特征分析

Analysis of clinical and pathological characteristics of multifocal and multicentric breast cancer

目的探讨多灶性多中心性乳腺癌的临床病理特征。方法多灶性多中心性乳腺癌组56例,单一病灶性乳腺癌(对照组) 150例,分析多灶性多中心性乳腺癌的临床病理特征。结果多灶性多中心性乳腺癌组及对照组组织学类型为浸润性小叶癌者分别占8. 9%、2. 0%,淋巴结转移率分别为69. 6%、51. 3%,淋巴脉管侵犯率分别为为35. 7%、13. 3%,行乳腺癌全乳切除术和保乳术者各占92. 9%、77. 3%和7. 1%、22. 7%,差异均有统计学意义(P <0. 05)。彩超对多灶性多中心性乳腺癌检出敏感性为73. 2%,乳腺钼靶X线摄影检查敏感率为为51. 8%,差异有统计学意义(P <0. 05),两者联合对该类病人检出敏感性为82. 1%。结论和单一病灶性乳腺癌比较,多灶性多中心性乳腺癌淋巴结转移多、淋巴脉管侵犯率高、为浸润性小叶癌的比例高。术前彩超联合钼靶检查能提高多灶性多中心性乳腺癌的诊断率。在切缘阴性的前提下,多灶性乳腺癌可行乳腺癌保乳术。

Objective To investigate the clinical and pathological characteristics of multifocal and multicentric breast cancer. Methods We collected data of 56 cases of multifocal and multicentric breast cancer and 150 cases of unifocal breast cancer( control group) to analyze the clinicopathological features of multifocal and multicentric breast cancer. Results In both the multifocal and multicentric breast cancer and the unifocal breast cancer group,we found the histological type which was invasive lobular carcinoma accounted for 8. 9% and 2. 0%,respectively. The lymph node metastasis rate was 69. 6% and51. 3%,respectively. The lymphatic vessel invasion rate was 35. 7% and 13. 3%,respectively. The mastectomy and breast-conserving surgery accounted for 92. 9%,77. 3% and 7. 1%,22. 7%,respectively.The differences were statistically significant( all P < 0. 05). The detection rate of ultrasonography in multifocal and multicentric breast cancer was 73. 2%,and that was 51. 8% of mammography. There was a significant difference between the two imaging methods( P < 0. 05). The sensitivity of the two imaging examinations combined to detect this type of patient was 82. 1%. Conclusion Compared to unifocal breast cancer,our findings suggest that the risk of axillary lymph node metastasis and lymphatic vascular invasion in multifocal and multicentric breast cancer was higher,and that had a high proportion of invasive lobular carcinoma. Preoperative ultrasonography combined with mammography can increase the accuracy of diagnosis of multifocal and multicentric breast cancer. Multifocal breast cancer can be treated with breast conserving surgery on the premise of negative margin.