Schwartz G F, Feig S A, Patchefsky A S
Cancer. 1978 Mar;41(3):1147-53. doi: 10.1002/1097-0142(197803)41:3<1147::aid-cncr2820410352>3.0.co;2-9.
Experience with 189 clinically occult, i.e., nonpalpable breast lesions is presented. The described technique of localization and excision all but guarantees removal of even the smallest radiographically suspicious findings with an inconspicuous incision and minimal breast deformity. The incidence of carcinoma encountered in these 189 biopsies is 27.5%. Axillary node metastases were present in less than 25% of the invasive nonpalpable cancers, approximately half of what might have been expected if the lesions had been discovered in the usual manner. There were no patients with axillary node metastases among those with in situ ductal or microinvasive ductal carcinomas. This implies a better prognosis and lower death rate from breast cancer in these patients. Screening programs employing mammography, designed to detect breast cancers in this pre-palpable stage, are encountered as a means of uncovering a higher proportion of such cancers at an earlier stage in their natural histories.
本文介绍了189例临床隐匿性（即触诊不到）乳腺病变的经验。所描述的定位和切除技术几乎能确保切除哪怕是最小的影像学可疑病灶，且切口不明显，对乳腺的畸形影响最小。在这189例活检病例中，癌的发生率为27.5%。在侵袭性触诊不到的癌症中，腋窝淋巴结转移的发生率不到25%，如果这些病变以常规方式被发现，预期发生率约为该比例的两倍。在原位导管癌或微浸润性导管癌患者中，没有腋窝淋巴结转移的病例。这意味着这些患者乳腺癌的预后更好，死亡率更低。采用乳腺X线摄影的筛查项目旨在在这个可触及之前的阶段检测乳腺癌，被视为一种在其自然病程的更早阶段发现更高比例此类癌症的手段。
