背景与目的:30岁以下青少年乳头状瘤病例较罕见,目前研究报道多见于高加索入种,国内此类报道较少,其与乳腺癌的关系尚不明确.本研究旨在了解中国青少年乳头状瘤的临床特点及与乳腺癌的关系.方法:对7例行手术治疗的30岁以下青少年乳头状瘤患者的临床病理及随访资料进行回顾性分析;患者均为女性,发病年龄11～29岁,中位年龄23岁;随访截至2010年12月31日,随访时间13～150个月,中位随访时间85个月.结果:青少年乳头状瘤患者以乳房肿块为主要表现,具有多灶性特征;除1例患者临床仅有乳头溢血、1例为肿物伴乳头溢血外,其余5例仅表现为乳房肿块;4例可触及多发肿物(占57.1%),其中l例肿物位于2个象限,1例为双侧乳腺肿块;7例患者临床及影像学诊断全部误诊;术后病理为重度乳头状瘤2例(占28.6%),为乳腺癌癌前病变,其中1例行全乳切除,病理证实除肿物外其他象限存在乳头状瘤病;随访中1例患者发生乳腺癌(占14.3%),此患者以多发肿物首次就诊,且具有乳腺癌家族史.结论:青少年乳头状瘤患者有较高的乳腺癌发生风险,乳腺癌家族史及多灶性病变是高危因素.%Background and purpose: Juvenile papillomatosis is a rare benign proliferative breast tumor that occurs in adolescence.Most reports on juvenile papillomatosis are found in Caucasians, with a few rare cases occurring in Chinese people.This study explored the clinical features of juvenile papillomatosis in Chinese people as well as the relationship between juvenile papillomatosis and breast cancer.Methods: A retrospective study was performed on 7 juvenile papillomatosis cases that underwent surgery trom Jan.1998 to Dec.2009.All patients were female, 11 to 29 years old, with a median age of 23-year-old.The data that was analyzed including family histories of breast cancer, clinical findings, surgery types and pathological characteristics.The postoperative follow-up were 13 to 150 months (the last follow-up was Dec.31st 2010), with a median follow-up period of 85 months.Results: The main clinical manifestation of juvenile papillomatosis was breast mass, and tend to be multiple.Of the 7 patients, 5 had palpable breast masses without nipple discharge, 1 had 1 breast mass with bloody nipple discharge, and 1 case with bloody nipple discharge only.Four patients (57.5％ of all cases) had more than 1 mass, including 1 patient who had multiple masses in different quadrants of the breast and 1 patient who had simultaneous bilateral breast masses.All 7 patients were misdiagnosed using physical examinations and imageology findings.Two patients had highly proliferative papillomatosis (28.6％ of all cases) after surgery, 1 patient received mastectomy, and found papillomatosis in different quadrants at pathological examination.One patient had developed breast cancer, this patient had multiple breast masses upon initial diagnosis as well as a family history of breast cancer.Conclusion: Juvenile papillomatosis has a high risk of developing into breast cancer.Therefore, patients with a family history of breast cancer or multiple papillomatosis have especially high risks.
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