乳头湿疹样癌的诊断与治疗(附27例病例分析)

The diagnosis and treatment of Paget disease of the breast

目的 探讨乳头湿疹样癌的临床表现、诊断、治疗及影响预后的因素。方法 回顾性总结1987年 10月～ 2 0 0 0年 12月西安交通大学第一医院收治的 2 7例乳头湿疹样癌病人的临床资料。结果 乳头湿疹样癌主要以乳头、乳晕区湿疹样病变及乳房肿块为首发症状。伴有乳房肿块的 5年及 10年生存率 (5 3.7% ,39.6 % )显著低于不伴有肿块的病人的 5年及 10年生存率 (10 0 % ,88.1% ) (P <0 .0 5 )。结论 对于对症处理 2周效果不佳的乳头、乳晕区湿疹样变应尽早行病灶刮片或切取活检 ,以明确诊断。

Objective To discuss clinical manifestation,diagnosis,treatment and factor related prognosis of Paget disease of the breast.Methods Twenty-seven patients with diagnosis of Paget disease of the breast were retrospectively reviewed at First Affiliated Hospital,Xi'an Jiaotong University from 1987.10 to 2000.12. Results The main clinical manifestation of Paget disease of the breast was eczematoid lesion of gross nipple and breast nodule.Patients with palpable nodule were 53.7% and 39.6% for 5 and 10 years survival rates,respectively,while patients without palpable nodule were 100% and 88.1% for 5 and 10 years surriral rates,respectively.There was significant difference( P <0.05) Conclusion If the effect of treatment to eczematoid lesion of gross nipple was not ideal,pathological examination should be implied.Modified radical mastectomy or racidal mastectomy is the fist choice in treatment of Paget disease of the breast with breast nodule.