Intracystic papillary carcinoma of the breast: Experience of a major Chinese cancer center
Intracystic papillary carcinoma of the breast: Experience of a major Chinese cancer center
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乳腺癌囊内乳头状癌：中国主要癌症中心的经验
DOI：
10.1016/j.prp.2018.01.006
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发表时间：
2018-04-01
影响因子：
2.8
通讯作者：
Gu, Lin
中科院分区：
文献类型：
--
作者：
Zhang, Jun;Zhang, Tiemei;Gu, Lin
背景：囊内型乳头状癌(IPC)是一种罕见的乳腺肿瘤。针对其临床特点的研究很少，有关其术前诊断、治疗和预后的数据也有限。本研究的目的是通过对2004年至2017年天津医科大学肿瘤研究所和天津医科大学附属医院收治的111例恶性卵巢癌患者的临床病理特征、预后的调查分析，探讨其手术治疗方法。追溯到2004年1月1日的病例的随访是通过回顾图表和患者问卷获得的。采用Kaplan-Meier方法评估患者的临床特征和生存情况。结果：肿瘤的中位大小为2.25 cm。中位年龄为62岁。在腋窝淋巴结清扫术(ALND)中，仅有1.1%(1/85)的患者发现有腋窝淋巴结转移。术前彩超诊断IPC的准确率为62.0%(62/100)，钼靶X线诊断IPC的准确率为63.5%(54/85)。中位随访期为52(2-149)个月。2、5、10年总生存率分别为98.9%、92.2%、85.6%，无复发率分别为99.1%、97.2%、92.0%。疾病特异性存活率为100%。结论：总体而言，我们报道了中国人群中IPC的一些独特特征。中国组乳腺IPC患者预后优于高加索等人种。影像诊断准确率低，易误诊为囊性或良性病变。术前核心针活检很难对IPC进行准确的病理诊断。IPC是一种局部疾病，腋窝淋巴结受累频率低，罕见的远处转移和良好的存活率。腋窝淋巴结转移率低，提示IPC宜采用四次切除+前哨淋巴结活检和保乳手术。
Background: Intracystic papillary carcinoma (IPC) is a rare breast neoplasm. There are few studies focusing on its clinical features and limited data about its preoperative diagnosis,treatment and outcomes. The purpose of this study is to explore specific characteristics of patients with IPC, investigate Its clinicopathological features, prognosis in China and confirm its surgery management.Methods: We identified 111 patients with IPC from the registry of Tianjin Medical University Cancer Institute and Hospital between 2004 and 2017. Follow-up of cases dating back to January 1, 2004 was obtained from retrospective chart review and patient questionnaires. Differences in clinical features and survival of patients were assessed using the Kaplan-Meier method.Results: The median tumor size was 2.25 cm. Median age was 62 years. In the cases of axillary lymph node dissection(ALND), only 1.1% (1/85) of patients with axillary lymph node metastasis were found. The diagnostic accuracy of preoperative Color Doppler ultrasound and Mammograms for IPC was 62.0% (62/100) and 63.5% (54/85) respectively. The median follow-up period was 52 (range2-149) months. The overall survival rate was 98.9%, 92.2%,and 85.6% at 2,5,and 10 years and the relapse-free rate was 99.1%,97.2%,and 92.0% at 2,5, and 10 years, respectively. The disease-specific survival rate was 100%.Conclusion: Overall, we report some unique features of IPC in the Chinese population. The patients of IPC of the breast in China have more excellent prognosis than in Caucasian and other races. The diagnostic accuracy of imaging was low, and was easily misinterpreted as a cyst or benign disease. Preoperative core needle biopsies are very difficult for accurate pathological diagnosis of IPC. IPC is a localized disease with a low frequency of axillary lymph node involvement, rare distant metastases and excellent survival. The low incidence of axillary lymph node metastasis suggests that quadrectomy + sentinel lymph node biopsy (SLNB) and breast-conserving surgery is recommended for IPC.