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目的研究乳腺外淋巴结转移为首发症状的乳腺癌手术治疗临床观察。方法回顾性分析两院收治的15例隐匿性乳腺癌患者的临床资料。15例患者在术前都行腋下肿块切除或行细针穿刺,经病理检查证实均为乳腺癌淋巴转移。对本组14例患者行乳腺癌根治术或改良根治术,1例因拒绝行根治术,仅行单侧淋巴结肿物切除术。14例中单纯行手术治疗者2例;单纯化疗1例;手术+放疗5例;手术+术后辅助化疗4例;手术+术后辅助化疗+放疗3例。对于伴有雌、孕激素受体阳性患者再辅以内分泌治疗。结果本组随访15例,1、2、3、4、5年存活分别为15例、14例、12例、11例、10例。结论在临床上对女性的腋窝肿块需给予高度警惕,应考虑隐匿性乳腺癌的可能。
Objective To investigate the clinical observation of surgical treatment of breast cancer with external lymph node metastasis as the first symptom. Methods The clinical data of 15 patients with occult breast cancer admitted to both hospitals were retrospectively analyzed. Fifteen patients underwent resection of submental masses or fine needle aspiration before surgery, and all lymph node metastases were confirmed by pathological examination. In this group, 14 patients underwent radical mastectomy or modified radical mastectomy, and 1 patient underwent radical resection only because of unilateral lymph node tumor resection. Among the 14 cases, 2 cases were treated with surgery alone; 1 case was chemotherapy alone; 5 cases were treated with surgery + radiotherapy; 4 cases were treated with surgery + postoperative adjuvant chemotherapy; 3 cases were treated with surgery + adjuvant chemotherapy + radiotherapy. For patients with positive estrogen and progesterone receptors supplemented with endocrine therapy. Results Fifteen patients were followed up in this group. The survival at 1, 2, 3, 4 and 5 years was 15 cases, 14 cases, 12 cases, 11 cases and 10 cases respectively. Conclusions Clinically, women should be highly vigilant about axillary masses, and the possibility of occult breast cancer should be considered.