目的：总结乳腺原位癌伴微小浸润的临床和病理特征，达到早期诊断和早期治疗的目的。方法选取2009年1月～2015年12月收治的18例符合乳腺 DCIS-MI 诊断的患者，对其临床资料特点、病理学特征、治疗方法和随访结果进行总结和分析。结果18例患者均符合原位癌伴微小浸润诊断标准，其中15例可以触及肿块，11例钼靶有恶性钙化表现（61.1%）。4例行改良根治术，3例行保乳手术，17例患者行前哨淋巴结活检，所有患者均未发生淋巴结转移。1例患者术后半年发生同侧浸润性乳腺癌，其余患者中位随访48个月未发生肿瘤复发或转移。结论原位癌伴微小浸润是原位癌向浸润性癌发展的中间阶段，预后良好。前哨淋巴结活检对于该类患者是最好的选择，如果阴性可以免做腋窝清扫，避免过度治疗。%Objective To summarize the clinical and pathological features of breast carcinoma in situ with minimal invasion, and to achieve the purpose of early diagnosis and early treatment. Methods To summarize and analyze the clinical data, pathologic features, treatment and follow-up results of 18 patients with DCIS-MI who were diagnosed during January 2009~December 2015. Results 18 cases of patients were in line with the diagnosis criteria of micro invasive carcinoma in situ, 15 of them can touch the tumor, and 11 cases had malignant calcification (61.1%). 4 cases underwent modified radical mastectomy, 3 cases underwent breast conserving surgery, and 17 patients underwent sentinel lymph node biopsy. All patients had no lymph node metastasis. 1 patient had the ipsilateral invasive breast cancer after 6 months, the rest of the patients were followed up for 48 months without tumor recurrence or metastasis. Conclusion Breast DCIS-MI is considered to be the interim stage in the progression from DCIS to IDC and the prognosis is good. Sentinel lymph node biopsy is the best choice for this type of patients, if the Sentinel lymph nodes are negative, the patients can be avoid axillary dissection.
展开▼
