Mitze M, Goepel E
Universitäts-Frauenklinik Hamburg-Eppendorf.
Geburtshilfe Frauenheilkd. 1989 Jul;49(7):635-41. doi: 10.1055/s-2008-1026669.
In 55 patients with medullary carcinoma of the breast follow-up data over an average period of 68.1 +/- 35.3 months were recorded. The histological slides of all tumors were retrospectively classified according to the same criteria. The parameters registered were: tumor-size, histological grading, receptor status, necrosis of tumor tissue, cellularity of the stroma, status of axillary nodes, reactive changes of axillary nodes and tumor invasion of lymphatic vessels. The importance of each parameter registered for disease-free survival and overall survival was calculated statistically using the log-rank-test. Of all parameters, only the nodal status of the axilla proved prognostically significant. Metastases of axillary nodes were demonstrable in only 31% of all MC. The incidence of nodal involvement proved to be less than in non medullary breast cancers. In 15 (27.3%) of the patients, progression of the tumor occurred. All women with distant metastases i.e. 12 (21.8%) died of the disease, whereas patients with only local recurrence of breast cancer are still alive. 72.7% of the patients showed relapse-free survival. Other parameters of proven prognostic value in breast cancers like receptor status and histological grading were of no relevance to the survival in MC. Prediction of prognosis depends on the correct classification of the tumor subgroup according to strict microscopical and macroscopical criteria.
对55例乳腺髓样癌患者进行了平均68.1±35.3个月的随访数据记录。所有肿瘤的组织学切片均根据相同标准进行回顾性分类。记录的参数包括：肿瘤大小、组织学分级、受体状态、肿瘤组织坏死、间质细胞密度、腋窝淋巴结状态、腋窝淋巴结反应性改变以及肿瘤对淋巴管的侵犯。使用对数秩检验对记录的每个参数对无病生存期和总生存期的重要性进行统计学计算。在所有参数中，只有腋窝淋巴结状态具有预后意义。在所有乳腺髓样癌中，只有31%可发现腋窝淋巴结转移。淋巴结受累的发生率低于非髓样乳腺癌。15例（27.3%）患者出现肿瘤进展。所有发生远处转移的女性，即12例（21.8%）死于该疾病，而仅出现乳腺癌局部复发的患者仍然存活。72.7%的患者无复发生存。乳腺癌中其他已证实具有预后价值的参数，如受体状态和组织学分级，与乳腺髓样癌的生存无关。预后的预测取决于根据严格的微观和宏观标准对肿瘤亚组进行正确分类。
