Liu Chunping, Pan Huaxiong, Li Zhi, Shi Lan, Huang Tao
Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Huazhong Univ Sci Technolog Med Sci. 2009 Feb;29(1):50-2. doi: 10.1007/s11596-009-0110-8. Epub 2009 Feb 18.
In order to investigate the relationship between the extent of tumor invasion and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and histologic grading in breast invasive ductal carcinoma as well as the optimal extent of excision during the breast-serving surgery, the clinical data of 104 patients with breast invasive ductal carcinoma who had received modified radical mastectomy were analyzed. The correlation analysis on invasive extent, which was evaluated by serial sections at an interval of 0.5 cm from 4 different directions taking the focus as the centre, and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and histologic grading was processed. There was a significant correlation between invasive extent and tumor size (r=0.766, P<0.01), and lymph nodes metastases (r=0.574, P<0.01), but there was no significant correlation between invasive extent and Her-2 expression (r=0.106, P>0.05), and histologic grading (r=0.228, P>0.05). The 100% negative rate of infiltration in patients without nipple discharge with tumor size <2, 2-3 and >3 cm was obtained at 1.5, 2.0 and 2.5 cm away from the tumor respectively. It is concluded that the performance of breast-serving surgery in patients with breast invasive ductal carcinoma should be evaluated by tumor size in combination with axillary lymph nodes involvement to decide the possibility of breast-serving and the secure excision extent.
为了探讨乳腺浸润性导管癌中肿瘤浸润范围与肿瘤大小、腋窝淋巴结转移、Her-2基因过表达及组织学分级之间的关系，以及保乳手术中最佳切除范围，对104例行改良根治性乳房切除术的乳腺浸润性导管癌患者的临床资料进行分析。以病灶为中心，从4个不同方向每隔0.5 cm进行连续切片评估浸润范围，并对其与肿瘤大小、腋窝淋巴结转移、Her-2基因过表达及组织学分级进行相关性分析。浸润范围与肿瘤大小（r=0.766，P<0.01）及淋巴结转移（r=0.574，P<0.01）之间存在显著相关性，但浸润范围与Her-2表达（r=0.106，P>0.05）及组织学分级（r=0.228，P>0.05）之间无显著相关性。肿瘤大小<2 cm、2 - 3 cm和>3 cm且无乳头溢液的患者，距肿瘤1.5 cm、2.0 cm和2.5 cm处的浸润阴性率分别为100%。结论是，乳腺浸润性导管癌患者保乳手术的实施应结合肿瘤大小及腋窝淋巴结受累情况来评估保乳的可能性及安全切除范围。
