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[与乳腺癌相关的乳腺病变。对200例切除标本的研究]

[Breast lesions associated with cancer of the breast. Study of 200 excision specimens].

作者信息

Vilde F, Arkwright S

机构信息

Service Central d'Anatomie et de Cytologie Pathologiques, Hôpital Boucicaut, Paris.

出版信息

Ann Pathol. 1987;7(4-5):279-84.

PMID:3435619
Abstract

Two hundred cases of breast carcinoma were studied, with particular attention to adjacent non-malignant modifications considered by some authors as preneoplastic changes. Diverse proliferative lesions were recognized in 82% of cases. Atypical hyperplasia was present in 51.5% of cases and was more often ductal (83/200) than lobular (40/200). Microscopic cysts were noted in 72% of cases. Calcifications, easily identified by mammography were present in 20% of cases and were associated with atypical hyperplasia in 4/5 of cases. The mean of patients was 58 years. For comparative studies of histologic lesions the following age categories were evaluated: category I less than 50 years (57 patients), category II greater than or equal to 50 years (143 patients). Atypical lobular hyperplasia, adenosis, and, to a lesser degree, sclerosing adenosis and macroscopic cysts were more frequently associated with breast cancer in women younger than 50. Fibro-atrophic or lipomatous changes were more often found in the older group of women, as expected. Sclerosing adenosis was significantly more frequent in breasts with multifocal infiltrating carcinoma. Such changes must be considered as risk factors by pathologists when present in mammary specimens without carcinomatous lesions, and careful study should be undertaken to locate a possible in situ microscopic carcinoma. No differences appeared in lesions associated with breast cancer in women with or without a familial history of breast cancer.

摘要

对200例乳腺癌病例进行了研究,特别关注一些作者认为是癌前病变的相邻非恶性改变。82%的病例中发现了不同的增殖性病变。51.5%的病例存在非典型增生,其中导管型(83/200)比小叶型(40/200)更常见。72%的病例中发现了微小囊肿。通过乳腺X线摄影容易识别的钙化在20%的病例中存在,其中4/5与非典型增生相关。患者的平均年龄为58岁。为了对组织学病变进行比较研究,评估了以下年龄类别:I类小于50岁(57例患者),II类大于或等于50岁(143例患者)。非典型小叶增生、腺病以及程度较轻的硬化性腺病和肉眼可见的囊肿在50岁以下的女性乳腺癌中更常见。正如预期的那样,纤维萎缩或脂肪瘤样改变在老年女性组中更常见。硬化性腺病在多灶浸润性癌的乳房中明显更常见。当这些改变出现在无癌性病变的乳腺标本中时,病理学家应将其视为危险因素,并应进行仔细研究以定位可能的原位微癌。有或无乳腺癌家族史的女性,其与乳腺癌相关的病变没有差异。

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