The incidence of multifocal(MF) and multicentric(MC) carcinomas varies widely among clinical studies,depending on definitions and methods for pathological sampling.Magnetic resonance imaging is increasingly used becau...The incidence of multifocal(MF) and multicentric(MC) carcinomas varies widely among clinical studies,depending on definitions and methods for pathological sampling.Magnetic resonance imaging is increasingly used because it can help identify additional and conventionally occult tumors with high sensitivity.However,false positive lesions might incorrectly influence treatment decisions.Therefore,preoperative biopsies must be performed to avoid unnecessary surgery.Most studies have shown higher lymph node involvement rates in MF/MC tumors than in unifocal tumors.However,the rate of local recurrences is usually low after breast conservative treatment(BCT) of MC/MF tumors.It has been suggested that BCT is a reasonable option for MC/MF tumors in women aged 50-69 years,with small tumors and absence of extensive ductal carcinoma in situ.A metaanalysis showed an apparent decreased overall survival in MC/MF tumors but data are controversial.Surgery should achieve both acceptable cosmetic results and negative margins,which requires thorough preoperative radiological workup and localization of lesions.Boost radiotherapy techniques must be evaluated since double boosts might result in increased toxicity,namely fibrosis.In conclusion,BCT is feasible in selected patients with MC/MF but the choice of surgery must be discussed in a multidisciplinary team comprising at least radiologists,surgeons and radiotherapists.展开更多
Objective This study was designed to investigate the prognostic implications of the intertumoral heterogeneity of molecular phenotype in multifocal and multicentric breast cancer(MMBC).Methods The clinical and follow-...Objective This study was designed to investigate the prognostic implications of the intertumoral heterogeneity of molecular phenotype in multifocal and multicentric breast cancer(MMBC).Methods The clinical and follow-up data of 146 patients with MMBC from Jan.2009to Dec.2009 treated in Tumor Hospital Affiliated to Zhengzhou University were retrospectively analyzed.展开更多
影像学技术的进步使得越来越多的多灶性/多中心性乳腺癌(multifocal/multicentric breast cancer, MMBC)在早期被发现。传统观念认为,MMBC比单灶性乳腺癌(unifocal breast cancer, UBC)预后更差,应积极升级治疗手段。近年来,随着医疗水...影像学技术的进步使得越来越多的多灶性/多中心性乳腺癌(multifocal/multicentric breast cancer, MMBC)在早期被发现。传统观念认为,MMBC比单灶性乳腺癌(unifocal breast cancer, UBC)预后更差,应积极升级治疗手段。近年来,随着医疗水平的提升,MMBC患者的诊断、个体化治疗、接受保乳手术的安全性等焦点问题需重新被审视。本文将从MMBC流行病学特征、术前影像学评估、病理异质性与分子标志物、手术方式等多方面展开论述,以期加深临床认知。展开更多
Paget＇s disease of the breast is an uncommon disorder that accounts＇for 1% to 3% of all mammary tumors. The incidence of underlying carcinoma associated with Paget＇s disease has been reported in 82% to 100% of case...Paget＇s disease of the breast is an uncommon disorder that accounts＇for 1% to 3% of all mammary tumors. The incidence of underlying carcinoma associated with Paget＇s disease has been reported in 82% to 100% of cases. The finding of underlying carcinoma reaches almost 100% when a palpable lump is also present. In this rare case, we described a patient presenting with Paget＇s disease but no palpable lump. However, we found 11 independent regions which were all invasive ductal carcinoma after the operation. Considering this patient, we should pay more attention to a multifocal and multicentric breast carcinoma associated with Paget＇s disease. Furthermore, we believe the mammography examination and a modified radical mastectomy are the most appropriate treatments for this population in clinical practice.展开更多
目的:探讨乳腺原位癌伴微小浸润(breast carcinoma in situ with microinvasion,BCIS-Mi)的临床病理特征。方法:回顾性收集121例乳腺BCIS-Mi患者的临床资料,分析肿瘤大小、组织学级别、粉刺样坏死、肿瘤浸润淋巴细胞(tumour-infiltratin...目的:探讨乳腺原位癌伴微小浸润(breast carcinoma in situ with microinvasion,BCIS-Mi)的临床病理特征。方法:回顾性收集121例乳腺BCIS-Mi患者的临床资料,分析肿瘤大小、组织学级别、粉刺样坏死、肿瘤浸润淋巴细胞(tumour-infiltrating lymphocytes,TILs)、浸润灶数量、浸润灶类型、淋巴结转移情况等指标之间的关系。结果:121例乳腺BCIS-Mi患者均为女性,86.0%(104/121)的患者为高级别导管原位癌,其中1例为大汗腺型原位癌,7例伴有乳头Paget病,2例伴有小叶原位癌;14.0%(17/121)为中级别原位癌,其中1例为原位实性乳头状癌,1例伴小叶原位癌。54.5%患者可见粉刺样坏死,63.6%的患者具有多个浸润灶,43.0%的患者原位癌导管周围见TILs,26.4%的患者浸润灶富于TILs(浸润灶中淋巴细胞/间质>30%)。121例BCIS-Mi中仅6.6%出现淋巴结转移,主要集中在多个浸润灶且浸润灶中TILs少的患者。结论:乳腺高级别的BCIS易发生微浸润,肿物>3.5 cm者易出现多个浸润灶。微小浸润灶数量多、间质TILs少是BCIS-Mi发生淋巴结转移的危险因素。展开更多
文摘The incidence of multifocal(MF) and multicentric(MC) carcinomas varies widely among clinical studies,depending on definitions and methods for pathological sampling.Magnetic resonance imaging is increasingly used because it can help identify additional and conventionally occult tumors with high sensitivity.However,false positive lesions might incorrectly influence treatment decisions.Therefore,preoperative biopsies must be performed to avoid unnecessary surgery.Most studies have shown higher lymph node involvement rates in MF/MC tumors than in unifocal tumors.However,the rate of local recurrences is usually low after breast conservative treatment(BCT) of MC/MF tumors.It has been suggested that BCT is a reasonable option for MC/MF tumors in women aged 50-69 years,with small tumors and absence of extensive ductal carcinoma in situ.A metaanalysis showed an apparent decreased overall survival in MC/MF tumors but data are controversial.Surgery should achieve both acceptable cosmetic results and negative margins,which requires thorough preoperative radiological workup and localization of lesions.Boost radiotherapy techniques must be evaluated since double boosts might result in increased toxicity,namely fibrosis.In conclusion,BCT is feasible in selected patients with MC/MF but the choice of surgery must be discussed in a multidisciplinary team comprising at least radiologists,surgeons and radiotherapists.
文摘Objective This study was designed to investigate the prognostic implications of the intertumoral heterogeneity of molecular phenotype in multifocal and multicentric breast cancer(MMBC).Methods The clinical and follow-up data of 146 patients with MMBC from Jan.2009to Dec.2009 treated in Tumor Hospital Affiliated to Zhengzhou University were retrospectively analyzed.
文摘影像学技术的进步使得越来越多的多灶性/多中心性乳腺癌(multifocal/multicentric breast cancer, MMBC)在早期被发现。传统观念认为,MMBC比单灶性乳腺癌(unifocal breast cancer, UBC)预后更差,应积极升级治疗手段。近年来,随着医疗水平的提升,MMBC患者的诊断、个体化治疗、接受保乳手术的安全性等焦点问题需重新被审视。本文将从MMBC流行病学特征、术前影像学评估、病理异质性与分子标志物、手术方式等多方面展开论述,以期加深临床认知。
文摘Paget＇s disease of the breast is an uncommon disorder that accounts＇for 1% to 3% of all mammary tumors. The incidence of underlying carcinoma associated with Paget＇s disease has been reported in 82% to 100% of cases. The finding of underlying carcinoma reaches almost 100% when a palpable lump is also present. In this rare case, we described a patient presenting with Paget＇s disease but no palpable lump. However, we found 11 independent regions which were all invasive ductal carcinoma after the operation. Considering this patient, we should pay more attention to a multifocal and multicentric breast carcinoma associated with Paget＇s disease. Furthermore, we believe the mammography examination and a modified radical mastectomy are the most appropriate treatments for this population in clinical practice.
文摘目的:探讨乳腺原位癌伴微小浸润(breast carcinoma in situ with microinvasion,BCIS-Mi)的临床病理特征。方法:回顾性收集121例乳腺BCIS-Mi患者的临床资料,分析肿瘤大小、组织学级别、粉刺样坏死、肿瘤浸润淋巴细胞(tumour-infiltrating lymphocytes,TILs)、浸润灶数量、浸润灶类型、淋巴结转移情况等指标之间的关系。结果:121例乳腺BCIS-Mi患者均为女性,86.0%(104/121)的患者为高级别导管原位癌,其中1例为大汗腺型原位癌,7例伴有乳头Paget病,2例伴有小叶原位癌;14.0%(17/121)为中级别原位癌,其中1例为原位实性乳头状癌,1例伴小叶原位癌。54.5%患者可见粉刺样坏死,63.6%的患者具有多个浸润灶,43.0%的患者原位癌导管周围见TILs,26.4%的患者浸润灶富于TILs(浸润灶中淋巴细胞/间质>30%)。121例BCIS-Mi中仅6.6%出现淋巴结转移,主要集中在多个浸润灶且浸润灶中TILs少的患者。结论:乳腺高级别的BCIS易发生微浸润,肿物>3.5 cm者易出现多个浸润灶。微小浸润灶数量多、间质TILs少是BCIS-Mi发生淋巴结转移的危险因素。
