隐匿性乳腺癌的治疗选择及预后因素分析

摘要

Objective:Occult breast cancer (OBC) accounts for 0.3%-1.0%of all breast cancers. Because of the rarity of this dis-ease, its treatment and prognosis remain unclear. Our study evaluated the treatment outcomes and prognostic factors associated with OBC. Methods:A total of 82 patients diagnosed with OBC based on available criteria were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China, between January 1968 and June 2014. Except for 16 patients who were treated by needle biopsy or excisional biopsy only and were subsequently excluded, all of the cases reported were included in the study. Of the remaining 66 patients, one was male. Patient data, tumor characteristics, and treatment and outcome variables were evaluated. Overall survival (OS) and disease-free survival (DFS) were analyzed. A unicentric retrospective review of 66 patients with OBC was performed. Re-sults:The median follow-up was 75.5 months (7.0-328.0). No significant differences in OS and DFS were observed between patients who underwent mastectomy plus axillary lymph node dissection (Mast+ALND) and those who underwent breast conservation surgery (P>0.05). Univariate analysis revealed that nodal status is a significant prognosis factor of DFS (P=0.031). Conclusion:No significant difference in treatment outcomes between mastectomy+ALND and breast conservation surgery was observed. Nodal status may be an independent predictor of poor outcomes in OBC patients.%目的：探讨隐匿性乳腺癌的治疗方法和预后。方法：回顾性分析中国医学科学院肿瘤医院1968年1月至2014年6月收治的66例隐匿性乳腺癌患者的临床病理及治疗转归资料。结果：患者中位生存期为75.5（7.0～328.0）个月，仅行腋窝淋巴结清扫的保乳手术与改良根治术者的总生存和无病生存差异无统计学意义（P>0.05）。单因素分析提示腋窝淋巴结分期是唯一可能与无病生存（P=0.035）相关的因素。结论：隐匿性乳腺癌患者保乳术和乳房全切术对于预后无明显影响。腋窝淋巴结转移数目多可能提示预后不良。