协和医学杂志

2014, v.5(01) 35-40

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年轻乳腺恶性肿瘤患者的临床病理与超声声像图特征
Clinicopathological and Sonographic Features of Breast Malignant Tumors in Young Women

孝梦甦;朱庆莉;姜玉新;戴晴;李建初;王红燕;游珊珊;张璟;刘赫;
XIAO Meng-su;ZHU Qing-li;JIANG Yu-xin;DAI Qing;LI Jian-chu;WANG Hong-yan;YOU Shan-shan;ZHANG Jing;LIU He;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

摘要(Abstract):

目的总结年轻乳腺恶性肿瘤患者的临床病理特征及超声声像图特征。方法回顾性分析2007年1月至2008年12月在本院进行手术并被病理证实为乳腺恶性肿瘤的40例年轻患者(≤35岁)的临床病理资料与超声影像资料。结果 40例患者平均年龄(29.88±5.12)岁。14例患者(35%)有肿物短期内快速生长病史。3例患者为妊娠哺乳期乳腺癌。35例患者(共40个恶性病灶)接受超声检查,超声漏诊5个病灶,误诊4个病灶,31个病灶在术前超声诊断为恶性肿瘤,诊断准确率为77.5%。超声声像图主要表现为形态不规则(97.1%)、边界不清(82.9%)、内部回声不均匀(97.1%)、微小钙化常见(74.3%)、血流丰富(Ⅱ~Ⅲ级80.0%)。15例(37.5%)患者采用保乳术,4例(10.0%)采用乳房单纯切除术,21例(52.5%)采用乳腺癌改良根治术。病理类型以浸润性导管癌最常见,占67.5%(27/40)。22例(55%)患者有腋窝淋巴结转移。对40例患者平均随访(64.08±5.87)个月,8例(20%)患者出现复发或转移。平均复发时间为术后(17.17±12.02)个月。结论年轻乳腺恶性肿瘤患者的肿瘤复发率高,淋巴结转移率高,超声声像图表现多样。
Objective To summarize the clinicopathological and sonographic features of breast malignant tumors in young women.Methods We retrospectively analyzed the clinical,pathological,and sonographic data of 40 young women( ≤35 years) with pathologically proven malignant tumors of the breast udergoing operation in our hospital from January 2007 to December 2008.Results The mean age of these 40 women was( 29.88 ± 5.12) years.The tumors grew rapidly in 14 patients( 35%).Three women were at pregnancy or lactation period.Thirty-five patients with a total of 40 malignant tumors underwent ultrasound examination,among which 5 tumors( 12.5%) were missed,4( 10.0%) misdiagnosed as benign tumors,and 31 correctly diagnosed as malignant tumors,yielding an accuracy of 77.5%.The sonographic features of the malignant tumors in young women were as follows:irregular shape( 97.1%),ill-defined margin( 82.9%),heterogeneous echostructure( 97.1%),microcalcifications( 74.3%),and rich blood flow( grade Ⅱ-Ⅲ)( 80.0%).Fifteen women( 37.5%) underwent breast-conserving surgery,4( 10.0%) underwent simple breast resection,and 21( 52.5%) underwent modified radical mastectomy.Invasive ductal carcinoma was the most common pathological type( n = 27,67.5%).Axillary lymph node metastasis was found in 22 women( 55%).During the follow-up [( 64.08 ±5.87) months; range,56-78 months],8( 20%) patients suffered from recurrence or metastasis.The average time for recurrence was( 17.17 ± 12.02) months( range,4.0-36.0 months) after the surgery.Conclusion The recurrent rate and lymph node metastasis rate of breast malignant tumors are high in young women after surgical treatment,along with complicated and diverse sonographic features.

关键词(KeyWords): 乳腺;恶性肿瘤;年轻患者;超声
breast;malignant tumor;young patient;ultrasonography

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基金项目(Foundation): 国家自然科学基金(81201112)

作者(Author): 孝梦甦;朱庆莉;姜玉新;戴晴;李建初;王红燕;游珊珊;张璟;刘赫;
XIAO Meng-su;ZHU Qing-li;JIANG Yu-xin;DAI Qing;LI Jian-chu;WANG Hong-yan;YOU Shan-shan;ZHANG Jing;LIU He;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

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