妊娠期乳腺癌的超声诊断研究(1)
【摘要】 目的：总结妊娠期乳腺癌额超声特征及超声对早期诊断妊娠期乳腺癌的临床应用价值。方法：回顾分析2015年3月-2017年2月在本院及市博爱医院就诊的妊娠期乳腺癌患者48例，总结妊娠期乳腺癌的超声特征，并对其病理类型与超声检查结果进行对比分析。结果：48例患者中，浸润性导管癌36例，髓样癌7例，导管内癌5例。其中40例超声检查发现明确肿块，6例可见微小钙化，2例误诊，超声诊断确诊率94%。但诊断时分期较晚，其中10例患者诊断时处于stage Ⅰ，17例患者诊断时处于stage Ⅱ，21例患者诊断时处于stage Ⅲ。本组5例早期妊娠患者病期为Ⅱ期，在终止妊娠后，对患侧乳腺癌进行改良根治术，在随访的24、48个月时患者恢复良好，未见复发病灶；余43例患者孕期均行乳腺癌改良根治术，其中12例患者足月顺产，18例患者足月后行剖宫产，6例患者术后两个月引产后接受放疗和化疗，7例失访。结论：妊娠期乳腺癌恶性程度高，进展期病例多，预后较差，超声有助于早期明确诊断，改善预后。
【关键词】 妊娠期； 乳腺癌； 超声
Ultrasound Diagnosis of Breast Cancer during Pregnancy/LIU Wen-min，LIANG Zhang-yan，ZHAO Xiang-jun，et al.//Medical Innovation of China，2017，14(10)：111-114
【Abstract】 Objective：To summarize the ultrasonographic features and diagnostic value in breast cancer during pregnancy.Method：The ultrasonographic features of breast cancer in 48 pregnant patients who were treated from March 2015 to February 2017 in our hospital were analyzed retrospectively and summarized.Result：Among 48 pregnant patients，there were 36 cases with invasive ductal carcinoma，7 cases with medullary carcinoma，and 5 cases with intraductal carcinoma.Among them，there were 40 cases with definite visible lump on ultrasound，6 cases with micro calcification on ultrasound，and 2 cases misdiagnosed，yielding an accurate rate of 94%.While most cases were diagnosed at advanced stage， with 10 cases at stage Ⅰ，17 cases at stage Ⅱ，and 21 cases at stage Ⅲ.Among all the patients，5 patients at stage Ⅱ were treated with modified radical mastectomy for breast cancer after the termination of early pregnancy and recovered well after the follow-up of 24 months and 48 months.And the other 43 pregnant patients underwent modified radical mastectomy for breast cancer， among whom， there were 12 cases with full-term birth，18 cases with full-term cesarean delivery，6 cases with radiotherapy and chemotherapy followed by induced labor 2 months after surgery，7 cases were lost to follow-up.Conclusion：Breast cancer during pregnancy is of high malignancy with a large number of advanced cases and poor prognosis.And ultrasound is helpful for early diagnosis and improved prognosis.
【Key words】 Pregnancy； Breast cancer； Ultrasound
First-author’s address：The Torch Development District Hospital of Zhongshan，Zhongshan 528437，China
doi：10.3969/j.issn.1674-4985.2017.10.031
妊娠期乳腺癌是指乳腺癌的發生在妊娠期和/或哺乳期，即在妊娠或分娩一年内新发生的乳腺癌[1-2]，是妊娠期最常见的恶性肿瘤之一。目前约每3000个新发乳腺癌中有一个处于妊娠期，15%绝经前妇女乳腺癌发生于妊娠期，且妊娠期乳腺癌发病率呈增高趋势[3]。由于妊娠期乳腺癌其特有的生物学特性和临床表现，因此在诊断、治疗及预后方面均有其特殊性。发现时多有淋巴结转移，5年的生存率也非常低，临床处理需要外科、产科和儿科等多学科协作，因此早期诊断、规范化的治疗非常重要。本文回顾分析48例妊娠期乳腺癌患者，总结超声特征及早期诊断的重要意义，现报道如下。, 百拇医药(刘文敏 梁章焱 赵相军 赖胜坤)
【关键词】 妊娠期； 乳腺癌； 超声
Ultrasound Diagnosis of Breast Cancer during Pregnancy/LIU Wen-min，LIANG Zhang-yan，ZHAO Xiang-jun，et al.//Medical Innovation of China，2017，14(10)：111-114
【Abstract】 Objective：To summarize the ultrasonographic features and diagnostic value in breast cancer during pregnancy.Method：The ultrasonographic features of breast cancer in 48 pregnant patients who were treated from March 2015 to February 2017 in our hospital were analyzed retrospectively and summarized.Result：Among 48 pregnant patients，there were 36 cases with invasive ductal carcinoma，7 cases with medullary carcinoma，and 5 cases with intraductal carcinoma.Among them，there were 40 cases with definite visible lump on ultrasound，6 cases with micro calcification on ultrasound，and 2 cases misdiagnosed，yielding an accurate rate of 94%.While most cases were diagnosed at advanced stage， with 10 cases at stage Ⅰ，17 cases at stage Ⅱ，and 21 cases at stage Ⅲ.Among all the patients，5 patients at stage Ⅱ were treated with modified radical mastectomy for breast cancer after the termination of early pregnancy and recovered well after the follow-up of 24 months and 48 months.And the other 43 pregnant patients underwent modified radical mastectomy for breast cancer， among whom， there were 12 cases with full-term birth，18 cases with full-term cesarean delivery，6 cases with radiotherapy and chemotherapy followed by induced labor 2 months after surgery，7 cases were lost to follow-up.Conclusion：Breast cancer during pregnancy is of high malignancy with a large number of advanced cases and poor prognosis.And ultrasound is helpful for early diagnosis and improved prognosis.
【Key words】 Pregnancy； Breast cancer； Ultrasound
First-author’s address：The Torch Development District Hospital of Zhongshan，Zhongshan 528437，China
doi：10.3969/j.issn.1674-4985.2017.10.031
妊娠期乳腺癌是指乳腺癌的發生在妊娠期和/或哺乳期，即在妊娠或分娩一年内新发生的乳腺癌[1-2]，是妊娠期最常见的恶性肿瘤之一。目前约每3000个新发乳腺癌中有一个处于妊娠期，15%绝经前妇女乳腺癌发生于妊娠期，且妊娠期乳腺癌发病率呈增高趋势[3]。由于妊娠期乳腺癌其特有的生物学特性和临床表现，因此在诊断、治疗及预后方面均有其特殊性。发现时多有淋巴结转移，5年的生存率也非常低，临床处理需要外科、产科和儿科等多学科协作，因此早期诊断、规范化的治疗非常重要。本文回顾分析48例妊娠期乳腺癌患者，总结超声特征及早期诊断的重要意义，现报道如下。, 百拇医药(刘文敏 梁章焱 赵相军 赖胜坤)