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[超声诊断乳腺前缘中断的导管原位癌——病例报告]

[Diagnosis of ductal carcinoma in situ with interruption of the anterior border of the mammary gland by ultrasonography-a case report].

作者信息

Sakurai Kenichi, Fujisaki Shigeru, Maeda Tetsuyo, Nagashima Saki, Hara Yukiko, Tomita Ryouichi, Suzuki Shuhei, Enomoto Katsuhisa, Amano Sadao

机构信息

Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2013 Nov;40(12):2360-2.

Abstract

We report a case of ductal carcinoma in situ( DCIS) with interruption of the anterior border of the mammary gland by ultrasonography. The patient was a 41-year-old woman. The patient was identified by a focal asymmetric density on her left breast by screening mammography. Ultrasonography showed an ill-defined low echoic mass, 25 mm in diameter, in the A area of her left breast. The tumor had features consistent with the interruption of the anterior border of the mammary gland. Therefore, she was diagnosed with invasive ductal carcinoma of the breast. We performed a modified radical mastectomy with sentinel lymph node biopsy. A resected specimen led to a diagnosis of DCIS positive for estrogen receptor and progesterone receptor, and negative for HER2/neu protein expression. After surgery, she was administered tamoxifen. One year and 6 months after the operation, she is well without metastases. Ultrasonography is generally useful to differentiate between a DCIS lesion or an invasive ductal carcinoma lesion. However, in this case, we could not diagnose the tumor as DCIS by ultrasonography because the tumor was interrupted by the anterior border of the mammary gland. This case suggests that we should be cautious when diagnosing low echoic tumors with interruption of the anterior border of the mammary gland by ultrasonography.

摘要

我们报告一例通过超声检查发现乳腺前缘中断的导管原位癌(DCIS)病例。患者为一名41岁女性。患者通过乳腺钼靶筛查发现左乳有局灶性不对称密度影。超声检查显示左乳A区有一个直径25mm、边界不清的低回声肿块。该肿瘤具有与乳腺前缘中断相符的特征。因此,她被诊断为乳腺浸润性导管癌。我们进行了改良根治性乳房切除术并进行了前哨淋巴结活检。切除标本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DCIS。术后,她接受了他莫昔芬治疗。术后1年6个月,她情况良好,无转移。超声检查通常有助于区分DCIS病变和浸润性导管癌病变。然而,在本病例中,由于肿瘤被乳腺前缘中断,我们无法通过超声检查将该肿瘤诊断为DCIS。该病例提示,当通过超声检查诊断乳腺前缘中断的低回声肿瘤时,我们应谨慎。

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