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目的总结隐性乳腺癌的诊治方法 ,降低误诊误治的发生率。方法对12例经手术和病理证实的隐性乳腺癌患者的临床资料进行回顾性分析和总结。结果 12例均以腋窝淋巴结肿大为主诉入院,经触诊和影像学检查未发现乳房内包块。6例术前腋窝淋巴结切除病理学检查证实为腺癌转移,4例细针穿刺细胞学检查提示腺癌转移,2例术中快速冰冻切片病理学检查诊断为腺癌转移。12例均行改良根治二式手术(Auchin-closs)。术后常规病理学检查结果 :7例找到原发癌灶,乳腺腺病4例,1例未发现异常。腋窝淋巴结均有数目不等的腺癌转移。ER(+)8例,ER(-)4例。随访3～8年,术后生存期>5年者6例,3～5年4例,<3年2例。结论隐性乳腺癌是罕见的临床特殊表现类型的乳腺癌之一,极易误诊,误治。对临床上仅有腋窝淋巴结肿大而无特殊乳房体征者,应尽快确定其病理性质并尽早治疗,以免延误病情。
Objective To summarize the diagnosis and treatment of latent breast cancer and reduce the incidence of misdiagnosis and mistreatment. Methods The clinical data of 12 patients with implicit breast cancer confirmed by surgery and pathology were retrospectively analyzed and summarized. Results All the 12 cases were mainly admitted with axillary lymph node enlargement. No palpable masses were found by palpation and imaging examination. Six cases of axillary lymph node dissection before surgery confirmed pathological examination of adenocarcinoma metastasis, four cases of fine needle aspiration cytology prompted adenocarcinoma metastasis, two cases of rapid frozen section pathological examination diagnosed as adenocarcinoma metastasis. All 12 patients underwent modified radical surgery (Auchin-closs). Postoperative routine pathological examination results: 7 cases of primary foci, breast adenosis in 4 cases, 1 case found no abnormalities. Axillary lymph nodes vary in the number of adenocarcinoma metastasis. ER (+) 8 cases, ER (-) 4 cases. All cases were followed up for 3 to 8 years, 6 cases survived more than 5 years, 4 cases 3 to 5 years and 2 cases less than 3 years. Conclusion Recessive breast cancer is one of the rare clinical manifestations of breast cancer, easily misdiagnosed and mistakenly treated. On the clinical only axillary lymph nodes without special breast signs, as soon as possible to determine the pathological nature and treatment as soon as possible, so as not to delay the disease.