乳腺癌肉瘤23例临床病理分析
Breast Carcinosarcoma: A Clinicopathological Analysis of 23 Cases
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摘要:目的 分析乳腺癌肉瘤的临床特点和病理特征, 了解其生存状态, 旨在提高对本病的认识, 并探讨乳腺癌肉瘤最佳治疗方案。方法 复习23例乳腺癌肉瘤的临床病理资料, 总结手术前后治疗经过和随访结果。结果 23例乳腺癌肉瘤女性患者年龄30~83岁, 中位年龄51岁。术前乳腺钼靶和B超检查误诊率高, 诊断主要依据术后病理检查。淋巴结转移者8例(34.8%)。在接受激素受体检查的14例患者中, ER阳性1例(7.1%), PR阳性4例(28.5%), 其中12例接受了HER-2检查, 2例阳性(16.7%)。5年生存率为61.5%。结论 乳腺癌肉瘤发病率低, 临床特征缺乏特异性, 确诊主要依据术后病理。其生物学行为不同于一般乳腺癌, 治疗方法以手术为主, 术后辅以放化疗, 预后较一般乳腺癌差。通过加强对乳腺癌肉瘤的认识, 或许能够提出新的潜在的有效治疗方案, 最终改善该类肿瘤患者的预后。Abstract:Objectives To analyze the clinicopathologic features and prognosis of breast carcinosarcoma, as well as to determine the best treatment choice.Methods The data of 23 female patients(aged 30 to 83 years, median age of 51 years) with breast carcinosarcoma were retrospectively analyzed, and the surgical treatment and follow-up outcome were reviewed.Results The misdiagnosis rate by mammography and B ultrasound was very high; thus the diagnosis of this disease mainly depended on postoperative histopathological examination.Metastasis of axillary lymph nodes was found in 8 cases(8/23, 34.8%).In 14 of the total cases subjected to hormone receptor tests, the ER- and PR-positive rates were 7.1%(1 / 14) and 28.5%(4 / 14), respectively.Among 12 cases subjected to the Her-2 test.2 were Her-2 positive.The overall five-year survival rate was 61.5%.Conclusion Breast carcinosarcoma is extremely rare and its clinical features are atypical.Hence, its final diagnosis is mainly based on postoperative pathology.The patients in this study were treated with mastectomy, postoperative chemotherapy, and radiotherapy.Their prognoses were worse than those of common breast cancer patients.Improving the understanding of breast carcinosarcoma is helpful for developing novel and potentially effective treatment.
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