Finkelstein S D, Sayegh R, Thompson W R
Department of Pathology, Rhode Island Hospital, Brown University, Providence 02903.
Am Surg. 1993 Jul;59(7):410-4.
A 40-year-old woman underwent upper outer quadrantectomy breast biopsy which revealed extensive intraductal carcinoma, predominantly comedocarcinoma type, with high nuclear grade. Involved ducts were transected at the edge of the biopsy. Total mastectomy with low axillary lymph node dissection was performed 2 weeks later, showing residual intraductal carcinoma in the upper inner quadrant and no evidence of metastasis. Eight years later, the patient developed two separate foci of recurrent, invasive ductal carcinoma at the exit sites for mastectomy drainage in the subcutaneous skin of the upper abdomen. The mastectomy scar was clinically free of tumor. The biological basis for this unusual sequela of treated intraductal carcinoma is discussed together with its importance for management of early breast cancer.
一名40岁女性接受了乳房外上象限切除术活检，结果显示为广泛的导管内癌，主要为粉刺癌类型，核分级高。受累导管在活检边缘处被切断。两周后进行了全乳房切除术及低位腋窝淋巴结清扫术，结果显示上内象限有残留导管内癌，无转移迹象。八年后，患者在上腹部皮下乳房切除术引流口处出现两个独立的复发性浸润性导管癌病灶。乳房切除疤痕在临床上未发现肿瘤。本文讨论了这种经治疗的导管内癌不寻常后遗症的生物学基础及其对早期乳腺癌治疗的重要性。
