Wang W Y, Wang X, Gao J D, Wang J, Liu J Q, Wang X, Zhao D B
Department of Pancreatic and Gastric Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Department of Breast Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Zhonghua Zhong Liu Za Zhi. 2017 Jun 23;39(6):429-433. doi: 10.3760/cma.j.issn.0253-3766.2017.06.006.
Breast intraductal papillary tumors are clinically common diseases derived from the ducts. The aim of this study is to investigate the clinicopathological characteristics of intraductal papillary tumors and risk factors for carcinogenesis. The clinicopathological data of 674 patients with breast intraductal papillary tumors, who underwent surgery in the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences from January 2010 to July 2015, were retrospectively analyzed. The median follow-up time was 46 months. The 674 cases were classified into 547 intraductal papilloma, 88 cases of intraductal papillary carcinoma, 32 cases of intracystic papillary carcinoma, and 7 cases of solid papillary carcinoma of breast. After a median follow-up time of 46 months, 13 out of 547 (2.4%) intraductal papillomas had local recurrence in the original dissected quadrat, another 10 cases developed breast cancer in the original dissected quadrat. The 3-year recurrence-free survival rates in intraductal papilloma and intraductal papilloma accompanied with atypical ductal hyperplasia were 97.7% and 93.5%, respectively, the recurrence-free survival curves showed a significant difference (=0.011). Multivariate analysis indicated that atypical ductal hyperplasia was a major prognostic factor affecting the recurrence-free survival of intraductal papilloma (=0.183, 95%=0.054 to 0.777, =0.020). Four cases (3.1%) of intraductal papillary carcinoma had local recurrence. The logistic analysis showed that patient aged >45 years, clinical manifestations of a breast lump, maximum tumor diameter greater than 2 cm are possible clinical manifestation of malignant breast intraductal papillary tumors (=1.735, 95%=1.007-2.990, =0.047; =2.849, 95%=1.207-6.711, =0.017; =3.792, 95%=2.162-6.653, <0.001). Intraductal papillary tumors have a certain recurrence rate. Age, clinical features and tumor size may be predictive factors of intraductal papillary carcinoma.
乳腺导管内乳头状肿瘤是临床上常见的起源于导管的疾病。本研究旨在探讨导管内乳头状肿瘤的临床病理特征及癌变危险因素。回顾性分析了2010年1月至2015年7月在中国医学科学院肿瘤医院/国家癌症中心接受手术治疗的674例乳腺导管内乳头状肿瘤患者的临床病理资料。中位随访时间为46个月。674例患者分为乳腺导管内乳头状瘤547例、导管内乳头状癌88例、囊内乳头状癌32例、实性乳头状癌7例。中位随访46个月后，547例导管内乳头状瘤中有13例（2.4%）在原手术象限局部复发，另有10例在原手术象限发生乳腺癌。导管内乳头状瘤及伴非典型导管增生的导管内乳头状瘤的3年无复发生存率分别为97.7%和93.5%，无复发生存曲线差异有统计学意义（P=0.011）。多因素分析显示非典型导管增生是影响导管内乳头状瘤无复发生存的主要预后因素（P=0.183，95%CI=0.054至0.777，P=0.020）。导管内乳头状癌4例（3.1%）局部复发。Logistic分析显示年龄>45岁、乳腺肿块临床表现、最大肿瘤直径大于2 cm可能是乳腺恶性导管内乳头状肿瘤的临床表现（P=1.735，95%CI=1.007 - 2.99；P=0.047；P=2.849，95%CI=1.207 - 6.711；P=0.017；P=3.792，95%CI=2.162 - 6.653；P<0.001）。导管内乳头状肿瘤有一定的复发率。年龄、临床特征和肿瘤大小可能是导管内乳头状癌的预测因素。
