乳腺导管原位癌1例,临床表现不典型

Joyce Campodonio, Ana Oliveira, F. Machado
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摘要

乳腺导管原位癌(DCIS)是一种增殖性病变,是癌症的前兆,由于乳房x线摄影筛查,越来越多地被诊断出来。肿瘤大小本身并不能决定病变是原位还是侵袭性,因此需要强调的是,DCIS可以表现为可变扩展。我们报告一例44岁的女性患者,通过病理检查被诊断为乳腺大(12厘米)DCIS,无微侵犯。患者表现为右乳增多,无循环性乳痛,右乳头溢血。乳房x光检查不确定,超声提示炎症,切口活检显示DCIS核3级,外侧缘受损。行单纯乳房切除术及腋窝淋巴结取样。乳腺良恶性疾病的临床表现是多变的。女性报告的最常见症状是疼痛、可触及的肿块或乳头溢液。文献显示,这种类型的癌症的范围是可变的,在一篇综述中发现的导管内病变可达5.4厘米,比在该患者中发现的小。这一发现使得临床表现值得讨论。虽然乳房x光检查是诊断这种损伤最有效的方法,但临床乳腺检查应在所有妇科独立于患者年龄进行,因为它有助于诊断早期病变,考虑到它是一个可触及的病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
DUCTAL CARCINOMA IN SITU OF THE BREAST: A CASE REPORT WITH AN ATYPICAL CLINICAL PRESENTATION
Ductal carcinoma in situ (DCIS) of the breast is a proliferative lesion, precursor of cancer, which has been increasingly diagnosed due to mammographic screening. Tumor size itself does not determine whether the lesion is in situ or invasive, so it is essential to emphasize that DCIS can present with variable extension. We report a case of a 44-year-old female patient that was diagnosed a great (12 cm) DCIS of the breast without microinvasion through pathologic examination. The patient presented with an increase of the right breast, acyclic mastalgia and right bloody nipple discharge. Mammography was inconclusive, the ultrasound suggested inflammation and the incisional biopsy revealed DCIS nuclear grade 3 with compromised lateral margins. It was performed simple mastectomy and axillary node sampling. The clinical presentations of benign and malignant diseases of the breast are variable. The most common symptoms reported by women are pain, palpable mass or nipple discharge. The literature reveals that the extent of this type of cancer is variable, being found in a review intraductal lesions up to 5.4 cm, size smaller than that one that was found in this patient. This finding makes the clinical apresentation interesting to be discussed. Although mammography is the most efficient method to diagnose this injury, clinical breast exam should be performed in all gynecological independent of patient age because it is useful for diagnosing early lesion, considering that it is a palpable lesion.
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