Haga S, Makita M, Shimizu T, Iida T, Imamura H, Kajiwara T
Department of Surgery, Daini Hospital, Tokyo Womens Medical College, Japan.
Nihon Geka Gakkai Zasshi. 1990 Mar;91(3):411-8.
Two hundred and six patients with breast cancer t1 or t2 were subclassified histologically into the following 8 types; comedo type, papillary type, mucous type, papillotubular or cribriform type, small solid alveolar type, large solid alveolar type, sclerotic type and pure scirrhous type. The risk of remaining cancer with lumpectomy was investigated clinicopathologically in relation to intraductal spread and lymphatic invasion of cancer cells. The tumor invasion was classified into intraductal type, localized type or extraductal spreading type, and lymphatic invasion was divided into 2 grades, i.e., vicinity of the tumor and 5mm or more distant. 1. In cases of intraductal spread, the comedo type was the most frequent, followed by the papillary type and mucous type. 2. The small solid alveolar type accounted for the highest proportion, 22.7%, in the group with distant lymphatic invasion. 3. The incidence of lymph node metastasis was as high as 63.6% and 61.7% for the small solid alveolar type and pure scirrhous type. 4. In cases of intraductal spread, t1 accounted for 32.6% and t2 for 47.0%. 5. The incidence of positive lymph node metastasis was 28.9% for t1 and 52.0% for t2. Tumors associated with a higher risk of remaining cancer are those of the comedo type and papillary type in terms of intraductal spread, those of the small solid alveolar type and pure scirrhous type in terms of lymphatic invasion, and those measuring 2cm or more.
206例T1或T2期乳腺癌患者经组织学分类为以下8种类型：粉刺型、乳头型、黏液型、乳头小管型或筛状型、小实体肺泡型、大实体肺泡型、硬化型和单纯硬癌型。针对癌细胞的导管内扩散和淋巴浸润，通过临床病理研究了保乳手术残留癌的风险。肿瘤浸润分为导管内型、局限型或导管外扩散型，淋巴浸润分为2级，即肿瘤附近和距离肿瘤5mm或更远。1. 在导管内扩散的病例中，粉刺型最为常见，其次是乳头型和黏液型。2. 在远处淋巴浸润组中，小实体肺泡型占比最高，为22.7%。3. 小实体肺泡型和单纯硬癌型的淋巴结转移发生率分别高达63.6%和61.7%。4. 在导管内扩散的病例中，T1占32.6%，T2占47.0%。5. T1期阳性淋巴结转移发生率为28.9%，T2期为52.0%。就导管内扩散而言，残留癌风险较高的肿瘤是粉刺型和乳头型；就淋巴浸润而言，是小实体肺泡型和单纯硬癌型；以及直径2cm或更大的肿瘤。
