摘要
目的探讨80岁以上乳腺癌患者的临床及超声特点。方法 1993年9月至2012年10月在北京协和医院行手术切除、经病理证实且资料完整的80岁以上原发性乳腺癌患者60例,共62个病灶,分析其声像图特点、临床表现、治疗方法及预后。结果 60例患者中,50例(83.3%)因自行触及肿块就诊。病灶大小平均为(2.4±1.1)cm,病理类型以浸润性导管癌为主(75.8%,47/62),黏液癌为11.3%(7/62)。有44例患者(46个病灶)术前行超声检查,其中43个(93.5%)正确诊断。在有详细超声记录的45个病灶中,40个(88.9%)形态不规则,35个(77.8%)纵横比小于1,24个(53.3%)边界模糊,21个(46.7%)有钙化,16个(35.6%)后方回声衰减。45例患者(75.0%)行乳腺肿物扩大切除术,13例(21.7%)行乳腺癌改良根治术,2例(3.3%)行单纯乳腺切除术。术中无死亡病例,所有患者术后均未出现严重并发症。31例患者有随诊记录,其中7例(22.6%)发生复发或转移,1例死于心脏疾病。结论 80岁以上乳腺癌病灶较大,多数具有典型超声表现,术前诊断正确率高。患者淋巴结转移相对较少,预后较好,由于患者年龄较大,相对保守的手术治疗方法安全可行。
Objective To summarize the clinical and ultrasonic features of breast cancer in women aged 80 and older. Methods A total of 60 patients （62 lesions） aged 80 and older with pathologically confirmed breast cancer from September 1993 to October 2012 were enrolled in this study and their clinical manifestations, ultrasonic features, therapeutic methods, and prognoses were analyzed. Results Most patients （83.3%） went to see a doc- tor because of nodules touched by themselves. The average diameter of the carcinoma was （2.4 ±1.1 ） cm. Most tumors （75.8%） were invasive ductal carcinomas, followed by the mucinous carcinoma （11.3%）. Among the 45 lesions with ultrasound records, 40 （88.9%） were irregular in morphology; the aspect ratio of 35 lesions （77.8%） was less than 1 ; 24 lesions （53.3%） had indistinct boundary; calcification existed in 21 lesions （46. 7% ） ; and 16 lesions （35.6%） had rear echo attenuation. The preoperative diagnostic accuracy of ultrasonography was 93.5%. In addition, 45 patients （75.0%） underwent breast tumor extended resection, 13 （21.7%） received modified radical mastectomy, 2 patients （3.3%） underwent simple breast resection. No death was noted during the operation and there was no major peri-operative complications. Of 31 patients with complete follow-up records, 7 had recurrence or metastasis and 1 died of heart disease. Conclusions Most breast cancers in women older than 80 years are relatively large, with typical ultrasonic features. The preoperative diagnosis is often accurate. Few lymphatic metastases exist, and the prognosis is good. Conservative surgeries are preferred for these elderly patients.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2014年第1期57-60,共4页
Acta Academiae Medicinae Sinicae
基金
高等学校博士学科点专项科研基金(20121106130002)~~
关键词
80岁以上患者
乳腺癌
临床特点
超声
patients older than 80
breast cancer
clinical features
ultrasound
