Bauer T L, Pandelidis S M, Rhoads J E
Department of Surgery, York Hospital, Pennsylvania 17405.
J Am Coll Surg. 1994 May;178(5):427-30.
Carcinoma of the breast was studied in 100 women who underwent needle localization and open breast biopsy for lesions found by screening mammography from January 1980 to May 1987. The average age of the patients found to have carcinoma was 59.2 years, and 16 percent of patients were younger than 50 years of age. Pathologic examination revealed 62 patients with infiltrating ductal carcinoma, 31 patients with ductal carcinoma in situ, and seven patients with infiltrating lobular carcinoma. In 34 patients the carcinoma was microscopic. Thirty-six patients had carcinomas less than or equal to 1 centimeter, and 30 patients had carcinomas greater than 1 centimeter. Eighty-four patients were treated with total mastectomy and axillary dissection. Seven patients were treated with wide excision, axillary dissection and radiation therapy. Nine patients underwent lesser treatments. Among the 91 patients undergoing axillary dissection, 82 were node negative, eight had one to three positive nodes, and one had four or more positive nodes. One hundred percent of patients with ductal carcinoma in situ who underwent axillary dissections (24 of 31) were node negative. Only two patients received adjuvant hormonal therapy, and one woman received adjuvant chemotherapy. All patients were under observation for at least five years or to the time of death (mean follow-up period, 5.8 years). Of the 100 patients with complete follow-up, 92 are alive and disease free. Four patients with carcinoma that metastasized have died. Three patients are alive with known recurrence. One patient died of other causes six months after carcinoma was diagnosed. Widespread use of screening mammography coupled with judicious use of needle-localization biopsy will lead to the early diagnosis of carcinoma of the breast. Such early diagnosis of carcinoma does lead to an excellent (95 percent) five-year survival rate.
对1980年1月至1987年5月间因乳腺钼靶筛查发现病变而接受针定位和开放性乳腺活检的100名女性的乳腺癌情况进行了研究。被发现患有癌症的患者平均年龄为59.2岁，16%的患者年龄小于50岁。病理检查显示，62例为浸润性导管癌，31例为导管原位癌，7例为浸润性小叶癌。34例患者的癌症为显微镜下可见。36例患者的癌灶小于或等于1厘米，30例患者的癌灶大于1厘米。84例患者接受了全乳切除和腋窝淋巴结清扫术。7例患者接受了广泛切除、腋窝淋巴结清扫和放射治疗。9例患者接受了较小范围的治疗。在接受腋窝淋巴结清扫的91例患者中，82例淋巴结阴性，8例有1至3个阳性淋巴结，1例有4个或更多阳性淋巴结。接受腋窝淋巴结清扫的导管原位癌患者（31例中的24例）100%淋巴结阴性。只有2例患者接受了辅助激素治疗，1例女性接受了辅助化疗。所有患者均接受了至少5年的观察或直至死亡（平均随访期为5.8年）。在100例有完整随访资料的患者中，92例存活且无疾病。4例发生转移的癌症患者已死亡。3例患者存活但已知有复发。1例患者在确诊癌症6个月后死于其他原因。乳腺钼靶筛查的广泛应用以及针定位活检的合理使用将有助于乳腺癌的早期诊断。这种癌症的早期诊断确实能带来出色的（95%）五年生存率。
