Day T, Yeoman R R, Nelson G, Ferrara J J
Department of Surgery, University of South Alabama, Mobile 36688.
Am J Surg. 1988 Dec;156(6):446-9. doi: 10.1016/s0002-9610(88)80524-5.
Accurate analysis of hormone receptors in breast carcinoma is critical from prognostic and therapeutic standpoints. Controversy exists over whether there is receptor decay when specimens are obtained upon completion of, rather than prior to, mastectomy. In addition, the effect of mastectomy technique on receptor concentration has not been addressed. Twenty patients with breast carcinoma had biopsy specimens taken prior to and upon completion of modified radical mastectomy. Ten had axillary dissection followed by mastectomy (Group A). The others had mobilization of the breast before axillary dissection (Group B). The estrogen receptor concentration was higher in 14 of 20 premastectomy specimens. All 10 patients in Group B had positive receptors before mastectomy; 5 were negative after mastectomy. All seven patients in Group A with positive premastectomy receptors remained so postmastectomy. We concluded that if a tumor specimen for receptor analysis is not obtained prior to modified radical mastectomy, axillary dissection should precede breast mobilization.
从预后和治疗的角度来看，准确分析乳腺癌中的激素受体至关重要。对于在乳房切除术完成后而非之前获取标本时是否存在受体衰减存在争议。此外，乳房切除术技术对受体浓度的影响尚未得到探讨。20例乳腺癌患者在改良根治性乳房切除术之前和完成后均采集了活检标本。10例患者先进行腋窝清扫，然后进行乳房切除术（A组）。其他患者在腋窝清扫之前先游离乳房（B组）。20例乳房切除术前标本中有14例雌激素受体浓度较高。B组所有10例患者在乳房切除术之前受体均为阳性；5例在乳房切除术后为阴性。A组7例乳房切除术前受体为阳性的患者在乳房切除术后仍保持阳性。我们得出结论，如果在改良根治性乳房切除术之前未获取用于受体分析的肿瘤标本，则应在游离乳房之前先进行腋窝清扫。
