Deos P H, Norris H J
Am J Clin Pathol. 1982 Jul;78(1):1-7. doi: 10.1093/ajcp/78.1.1.
In this study, 145 well-differentiated (tubular) carcinomas were divided into two groups: 90 pure tubular carcinomas and 55 which were mixtures in that they contained a component of infiltrating duct carcinoma occupying less than half the tumor. Axillary lymph node metastases developed in 29% of women in the mixed group, but occurred in only 6% of the pure group. The prognosis was good in both groups, with five-year-actuarial survival rates in the pure and mixed groups of 100% and 93%, respectively. Residual carcinoma was present in the mastectomy specimen in 28% of the pure group, and in 40% of the mixed carcinomas. In addition, there was a recurrence rate of 50% in patients with pure tubular carcinoma treated by excisional biopsy. These features indicate simple excision of tubular carcinoma is likely to be inadequate therapy and that a mastectomy is warranted. Axillary node dissections should be done when there is a component of infiltrating duct carcinoma because of the increased risk of axillary lymph node metastasis.
在本研究中，145例高分化（管状）癌被分为两组：90例纯管状癌和55例混合性癌，后者含有占肿瘤不到一半的浸润性导管癌成分。混合组中29%的女性发生腋窝淋巴结转移，而纯组仅6%发生。两组预后均良好，纯组和混合组的五年精算生存率分别为100%和93%。纯组28%的乳房切除标本中存在残留癌，混合性癌中这一比例为40%。此外，接受切除活检治疗的纯管状癌患者复发率为50%。这些特征表明单纯切除管状癌可能是不充分的治疗方法，乳房切除术是必要的。当存在浸润性导管癌成分时，应进行腋窝淋巴结清扫，因为腋窝淋巴结转移风险增加。
