CAJ | 학술논문

目的:根治术,Ⅲ～Ⅳ期患者行改良根治术或根治术.组织学类型中最常见的为浸润性导管癌18例(47.4%),其中3例伴同侧乳头管腺瘤;单纯癌6例,导管内癌6例,腺癌伴灶性鳞癌分化3例,髓样癌3例,黏液腺癌2例.病理分期(根据AJCC乳腺癌分期,2002年第6版)中最常见的为Ⅱ、Ⅲ期,各12例(31.6%);Ⅰ期6例,Ⅳ期8例.全部患者随访1～23年,中位随访时间为6年7个月,随访率100%.随访至2008年11月,12例发生远处转移并死于该病,余26例健在.本组5年总生存率为35.3%(低于乳腺癌术后5年生存率66.8%,P<0.05),3年为77.8%;5年无瘤生存率为28.6%,3年为63.6%.结论:副乳腺癌是一种罕见且预后较差的恶性肿瘤.诊断主要依靠临床表现、影像学检查和术后病理诊断.应遵循以手术为主的综合治疗原则,术后辅助治疗有可能改善患者的生存期.
목적:근치술,Ⅲ～Ⅳ기환자행개량근치술혹근치술.조직학류형중최상견적위침윤성도관암18례(47.4%),기중3례반동측유두관선류;단순암6례,도관내암6례,선암반조성린암분화3례,수양암3례,점액선암2례.병리분기(근거AJCC유선암분기,2002년제6판)중최상견적위Ⅱ、Ⅲ기,각12례(31.6%);Ⅰ기6례,Ⅳ기8례.전부환자수방1～23년,중위수방시간위6년7개월,수방솔100%.수방지2008년11월,12례발생원처전이병사우해병,여26례건재.본조5년총생존솔위35.3%(저우유선암술후5년생존솔66.8%,P<0.05),3년위77.8%;5년무류생존솔위28.6%,3년위63.6%.결론:부유선암시일충한견차예후교차적악성종류.진단주요의고림상표현、영상학검사화술후병리진단.응준순이수술위주적종합치료원칙,술후보조치료유가능개선환자적생존기.
Objective: To study the clinicopathological characteristics，diagnosis，multiple modality therapy and prognosis of accessory breast cancer. Methods: Clinical data of 38 patients with accessory breast cancer seen in our hospital between October 1985 and November 2007. Results: The 38 cases of accessory breast cancer accounted for 0.15% of all 26,078 breast cancer cases during the same period.Six patients of stage Ⅰ and 3 patients of stage Ⅱ underwent breast-conserving local wide excision of the tumor plus axillary lymph node dissection,with the resection margins pathologically negative.The other 9 cases of stage Ⅱ patients were treated with Auchincloss mastectomy.Stage Ⅲ and stage Ⅳ patients were treated with Auchincloss or Halsted mastectomy.The most common histological type of accessory breast cancer was infiltrating ductal Carcinoma for 18 patients(47.4%)，of which 3 cases were associated with adenoma of the nipple tube.There were 6 cases of carcinoma simplex，6 cases of intraductal Carcinoma，3 cases of adenocarcinoma with focal squamous cancer cells differentiation，3 cases of medullary carcinoma，and 2 cases of mucinous adenocarcinoma.The most common pathological stages(according to AJCC staging of breast cancer,2002.6th edition)were stage Ⅱ and Ⅲ in 12 cases(31.6%)，stage Ⅰ in 6 cases，and stage Ⅳ in 8 cases.All patients were followed-up for 1 to 23 years.The median follow-up time was 6 years and 7 months，and the follow-up rate was 100%.Until November 2008，12 patients died of metastasis and the other 26 patients were still alive.The 5-year overall survival rate was 35.3%.significantly lower than that of breast cancer patients(66.8%).The 3-year survival rate was 77.8%.The 5-year disease free survivaI rate was 28.6%and the 3-year disease free survival rate was 63.6%. Conclusion: Accessory breast cancer is rarely seen but is aggressive.The diagnosis mainly depends on clinical characteristics，postoperative pathology and imaging examinations.Early diagnosis is essential.Surgery combined with other adjuvant therapies can improve patient survival.