Coexistence of nipple duct adenoma and breast carcinoma: a clinicopathologic study of five cases and review of the literature.
Coexistence of nipple duct adenoma and breast carcinoma: a clinicopathologic study of five cases and review of the literature.
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发表时间：
1995-08
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通讯作者：
M. W. Jones;F. Tavassoli
中科院分区：
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作者：
M. W. Jones;F. Tavassoli
乳头导管腺瘤（NDA）和癌同时发生在同一乳房是罕见的，通常被认为是偶然发现。报告了5例此类并发病变。患者年龄从48岁到70岁不等，均表现为可触及的肿块，其中3例位于乳晕下，2例位于下内象限。2例患者乳头变形并有溢液，另1例患者乳头糜烂，这提高了临床上Paget病的可能性。显微镜下，4名女性为浸润性导管癌，5名女性为导管内癌，均伴NDA。2例浸润性癌邻近NDA，位于乳头表面上皮的正下方；其中一例NDA有不典型导管内增生。3例患者行乳房切除术和腋窝淋巴结清扫，2例仅行切除活检。有4名妇女接受了随访，随访时间从1.5岁到8岁不等。其中1名妇女在诊断后8岁发生转移并死亡；剩下的三个人都活得很好。在至少三个病例中，临床未怀疑浸润性癌，并且由于继发于NDA的症状而进行了初始手术。
The simultaneous occurrence of nipple duct adenoma (NDA) and carcinoma in the same breast is rare and generally considered an incidental finding. Five examples of such concurrent lesions are reported. The patients ranged in age from 48 to 70 y, and they all presented with a palpable mass that was subareolar in three and in the lower inner quadrant in two women. The presence of distorted nipple with discharge in two patients and nipple erosion in another had raised the possibility of Paget's disease clinically. Microscopically, an infiltrating duct carcinoma was present in four women and an intraductal carcinoma in the fifth--all along with a NDA. Two of the invasive carcinomas were adjacent to the NDA and immediately beneath the surface epithelium of the nipple; the NDA in one of these had atypical intraductal hyperplasia. Three women had mastectomy and axillary node dissection, two had excisional biopsy only. Follow-up was available in four women and ranged from 1.5 to 8 y. One of these women developed metastasis and died 8 y postdiagnosis; the remaining three are alive and well. In at least three cases, the invasive carcinoma was not suspected clinically, and the initial procedure was done because of symptomatology secondary to the NDA.