Schwartz G F, Feig S A, Rosenberg A L, Patchefsky A S, Shaber G S
Recent Results Cancer Res. 1984;90:125-32. doi: 10.1007/978-3-642-82031-1_18.
Experience with 469 clinically occult breast lesions is presented. The overall incidence of malignancy observed was 32%, just about one in three. The technique of needle-guided biopsy is described, insuring precise localization and excision of minute radiographic findings, yet without leaving a conspicuous scar to remind the patient of her experience. Although it is too early to speculate about a possible increase in survival of these "earliest" breast cancers, the observed decreased incidence of axillary node metastasis implies a lowered death rate from breast cancer in these patients. It is not unreasonable to extrapolate the extent of patient salvage from axillary node status. Many of these cancers were uncovered in the course of screening asymptomatic patients, and this further implies the efficacy of such screening programs in the early detection of breast cancer. The surprisingly high incidence of multicentricity in these tiny cancers must not be ignored when recommending adequate and appropriate therapy for these impalpable malignancies.
本文介绍了469例临床隐匿性乳腺病变的经验。观察到的恶性肿瘤总体发生率为32%，约为三分之一。文中描述了针引导活检技术，该技术可确保精确定位并切除微小的影像学发现，且不会留下明显疤痕让患者想起这段经历。尽管现在推测这些“最早”乳腺癌患者的生存率可能提高还为时过早，但观察到的腋窝淋巴结转移发生率降低意味着这些患者的乳腺癌死亡率降低。根据腋窝淋巴结状态推断患者挽救程度并非不合理。这些癌症中有许多是在筛查无症状患者的过程中发现的，这进一步表明了此类筛查计划在早期发现乳腺癌方面的有效性。在为这些触诊不到的恶性肿瘤推荐充分且合适的治疗方法时，绝不能忽视这些微小癌症中多中心性的惊人高发生率。
