炎性乳腺癌和皮肤钻孔活检的重要性。
Inflammatory breast cancer and the importance of skin punch biopsy.
机构信息
Department of General Surgery, Division of Breast Surgery, Cleveland Clinic, Cleveland, OH, USA.
Department of General Surgery, Division of Breast Surgery, Cleveland Clinic, Cleveland, OH, USA.
出版信息
Am J Surg. 2023 Mar;225(3):549-552. doi: 10.1016/j.amjsurg.2022.11.017. Epub 2022 Nov 12.
BACKGROUND
The oncologic outcomes of patients diagnosed with inflammatory breast cancer (IBC) based on clinical exam only versus those with dermal lymphatic invasion on skin punch biopsy may be different and are worth further investigation.
METHODS
Patients diagnosed from 2006 to 2021 with IBC at our institution were grouped according to clinical diagnosis or skin biopsy performed. Oncologic and survival outcomes among groups were compared.
RESULTS
A total of 72 IBC patients were identified and grouped into 3 categories based on method of diagnosis: skin biopsy positive (n = 24), skin biopsy negative (n = 10) and no biopsy performed (n = 38). Skin biopsy positive patients had a higher incidence of lymphovascular invasion identified on final pathology and were more likely to experience a chest wall recurrence. At 5.1 yrs of follow-up, 40% of patients experienced recurrence, with 61% overall survival.
CONCLUSION
Clinical diagnosis remains diagnostic for IBC, but skin punch biopsy allows for improved oncologic insight.
背景
仅依据临床检查诊断为炎性乳腺癌（IBC）的患者与经皮肤打孔活检发现皮肤淋巴管浸润的患者的肿瘤学结局可能不同，值得进一步研究。
方法
本研究回顾性分析了 2006 年至 2021 年在我院诊断为 IBC 的患者，根据临床诊断或皮肤活检进行分组。比较各组的肿瘤学和生存结局。
结果
共纳入 72 例 IBC 患者，根据诊断方法分为 3 组：皮肤活检阳性（n=24）、皮肤活检阴性（n=10）和未行活检（n=38）。皮肤活检阳性患者最终病理检查中更常发现血管淋巴管浸润，且更易发生胸壁复发。在 5.1 年的随访中，40%的患者出现复发，总体生存率为 61%。
结论
临床诊断仍然是 IBC 的诊断方法，但皮肤打孔活检可提供更好的肿瘤学信息。
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