Suzuki Shuhei, Sakurai Kenichi, Nagashima Saki, Fujisaki Shigeru, Shibata Masahiko, Tomita Ryouichi, Hara Yukiko, Matsumoto Kyoko, Enomoto Katsuhisa, Amano Sadao
Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2011-3.
We report a locally advanced elderly breast carcinoma with skin invasion. The patient was a 96-year-old woman who had a breast lump. The palpable tumor was 3 .5 cm in diameter. Ultrasonography revealed a low echoic mass. A core needle biopsy for the breast tumor led to a diagnosis of an invasive ductal carcinoma positive for estrogen receptor and progesteron receptor, and negative for HER2/neu protein expression. She underwent a tumorectomy including the cancer invasive skin by local anesthesia. Because her respiratory function was unbearable to perform a muscle-preserving mastectomy with general anesthesia. The surgical margins of the resected specimen were negative. The clinicopathological stage, according to the UICC-pTNM classification, was Stage III C (T4b, N0, M0). After the operation, she was administered aromatase inhibitor. The patient has been well and remained disease-free during a follow-up period of 3 years. The surgical excision with local anesthesia was useful for locally advanced super senior breast cancer patients who were impossible to perform general anesthesia by various kinds of factors.
我们报告一例局部晚期伴皮肤侵犯的老年乳腺癌。患者为一名96岁女性,有乳腺肿块。可触及的肿瘤直径为3.5厘米。超声检查显示为低回声肿块。对乳腺肿瘤进行的粗针活检诊断为雌激素受体和孕激素受体阳性、HER2/neu蛋白表达阴性的浸润性导管癌。她在局部麻醉下接受了包括侵犯皮肤的肿瘤切除术。因为她的呼吸功能无法承受全身麻醉下的保乳手术。切除标本的手术切缘为阴性。根据UICC-pTNM分类,临床病理分期为ⅢC期(T4b,N0,M0)。术后,她接受了芳香化酶抑制剂治疗。患者情况良好,在3年的随访期内无疾病复发。对于因各种因素无法进行全身麻醉的局部晚期高龄乳腺癌患者,局部麻醉下的手术切除是有效的。