乳腺叶状肿瘤如何根治乳腺叶状肿瘤28例临床诊疗分析

乳腺叶状肿瘤如何根治乳腺叶状肿瘤28例临床诊疗分析 摘要 目的 探讨乳腺叶状肿瘤的临床特点、治疗方法以及影响预后的可能因素。 方法 回顾性分析我院xx年6月xx年8月收治的28例乳腺叶状肿瘤患者的临床资料。 结果 28例患者平均年龄34岁，但发病年龄两极分布较明显。其中19例为良性，9例为交界性。全部患者均手术治疗，其中乳腺区段切除术12例，扩大区段切除术15例，乳房单纯切除术1例。全部病例均术后随访，时间为648个月，2例复发，无死亡病例。 结论 乳腺叶状肿瘤发病率较低，发病年龄较广，青春期及围绝经期发病较为集中，需结合病史、影像学检查及穿刺/冰冻病理等因素明确诊断。规范手术治疗乳腺分叶状肿瘤效果确切。 关键词 乳腺；叶状肿瘤；分析 R737.9 C 1673-7210（xx）07（c）-0156-02 Analysis of clinical diagnosis and treatment of 28 cases of cystosara phyllodes LIU Shaojie1 PEI Xiaojuan2 PENG Weiqiang1 HUANG Yukang1 WENG Jianhua1 1.Department of Surgical Oncology, the Central Peoples Hospital of Huizhou City, Guangdong Province, Huizhou 516001, China; 2.Department of Pathology, the Central Peoples Hospital Huizhou City, Guangdong Province, Huizhou 516001, China Abstract Objective To investigate the clinical features, treatment and prognostic factors of cystosara phyllodes. Methods Clinical data of 28 cases of cystosara phyllodes admitted to the authors hospital from June xx to August xx were retrospectively analyzed. Results The average age of the 28 patients was 34 years old, but the age was of bipolar distribution. Of all the cases 19 were benign and 9 were borderline. All patients underwent surgical treatment, among which 12 cases underwent mammary section resection, 15 cases underwent expanded section resection and 1 underwent mastectomy. All patients were followed up for 6 to 48 months, during which time 2 cases had recurrence and no cases of death ourred. Conclusion Cystosara phyllodes has low incidence and wide spread of onset age. The most concentrated onset age is adolescence and perimenopausal period. Diagnosis should be confirmed with a bination of medical history, imaging and puncture/frozen pathological factors. Standardized surgical treatment of cystosara phyllodes has exact effect. Key words Mammary gland; Cystosara phyllodes; Analysis 乳腺叶状肿瘤（breast phyllodes tumors，BPT）是乳腺纤维上皮性肿瘤的一种，由纤维结缔组织和上皮组成，发病率占全部乳腺肿瘤的0.3%1.0%，约占乳腺纤维上皮性肿瘤的2.5%1。1982年WHO对乳腺疾病分类时明确为BPT，并根据病理特征分为良性、恶性和临界性3类。我院xx年6月xx年8月收治BPT患者28例，现将诊疗体会总结分析如下： 1 资料与方法 1.1 一般资料 BPT患者28例，均为女性。年龄1456岁，其中1420岁11例，4556岁14例，平均年龄38岁。病程2个月7年，平均22月。所有患者均为单侧乳腺单发病灶，肿物最大径325 cm，平均8.6 cm。皮肤破溃2例，同侧腋窝淋巴结肿大3例（2例为皮肤破溃患者）。超声下超声图像表现：分叶状肿块，多边界清楚，肿物实质主要呈中低回声，较大者（肿物最大径超过5 cm）可见回声不均匀及散在无回声区，钙化和后方回声增强较少见。乳腺钼靶可见肿瘤界限清楚，可