Oiwa Mikinao, Endo Tokiko, Ichihara Shu, Moritani Suzuko, Hasegawa Masaki, Iwakoshi Akari, Sato Yasuyuki, Morita Takako, Hayashi Takako, Kato Aya
Department of Radiology, Nagoya Medical Center, 4-1-1 Sannnomaru, Naka-ku, Nagoya, 460-0001, Japan,
Virchows Arch. 2015 Jul;467(1):71-8. doi: 10.1007/s00428-015-1769-9. Epub 2015 Apr 3.
Breast cancer is occasionally complicated by sclerosing adenosis (SA). Although both lesions usually originate in the terminal duct lobular unit, their pathogenetic relationship has not yet been elucidated. The present study analyzed 63 breast cancer patients with SA (involving a total of 75 breasts) to clarify if coexisting SA increased the frequency of multicentric breast cancer or not. Using the topographical classification proposed in our previous study, breast cancers with SA were classified into the following three types: type A (n = 22), cancer area was completely surrounded by the SA; type B (n = 26), cancer area partially overlapped the SA; and type C (n = 27), cancer area was located separate from the SA. Breast cancers with SA had a significant (P < 0.001) increase in frequency of harboring bilateral and multicentric cancers [17 of 63 (27%) and 15 of 63 (24%), respectively] when compared to breast cancer patients without SA, regardless of topographical type. Breast cancers with SA were less invasive (P < 0.001), of lower histological grade (P = 0.034), and had similar frequency of estrogen receptor-positive (P = 0.21) and HER2-positive (P = 0.74) tumors. In conclusion, contralateral and ipsilateral multicentric breast cancers occurred at a higher frequency in those with SA. Our data suggest that SA is, in addition to lobular neoplasia, a predictor of multicentric breast cancers.
乳腺癌偶尔会并发硬化性腺病（SA）。尽管这两种病变通常都起源于终末导管小叶单位，但其发病机制尚未阐明。本研究分析了63例患有SA的乳腺癌患者（共涉及75个乳房），以明确共存的SA是否会增加多中心性乳腺癌的发生率。采用我们先前研究中提出的地形学分类方法，将伴有SA的乳腺癌分为以下三种类型：A型（n = 22），癌灶完全被SA包围；B型（n = 26），癌灶部分与SA重叠；C型（n = 27），癌灶与SA分开。与无SA的乳腺癌患者相比，伴有SA的乳腺癌无论地形学类型如何，双侧和多中心癌的发生率均显著增加（P < 0.001）[分别为63例中的17例（27%）和63例中的15例（24%）]。伴有SA的乳腺癌侵袭性较小（P < 0.001），组织学分级较低（P = 0.034），雌激素受体阳性（P = 0.21）和HER2阳性（P = 0.74）肿瘤的发生率相似。总之，SA患者对侧和同侧多中心乳腺癌的发生率更高。我们的数据表明，除小叶肿瘤外,SA也是多中心乳腺癌的一个预测指标。
