目的探讨乳腺非典型小叶增生和小叶原位癌的生物学行为及治疗方法。方法回顾性分析1982年7月至1996年1月间的17例非典型小叶增生、35例小叶原位癌的临床及随访资料。随访时行门诊体检、乳腺钼靶摄片、乳腺B超等检查;随访时间为3~257个月,平均146.6个月。结果非典型小叶增生和小叶原位癌多发生于绝经前妇女(69.2%);52例患者均因各种良性病变行手术,术后病理证实为非典型小叶增生或小叶原位癌,其中25例(48.1%)有微钙化病变;有8例在随访期间癌变(5例在同侧乳房,3例在对侧乳房),平均癌变间期为9.4年;尽管4例(50%)有乳腺癌或卵巢癌家族史,但未发现非典型小叶增生和小叶原位癌癌变与乳腺癌或卵巢癌家族史有关(P〉0.05);同样,也未发现非典型小叶增生与小叶原位癌发生癌变的差异有统计学意义(P〉0.05)。结论非典型小叶增生和小叶原位癌局部切除是必要的。
OBJECTIVE: To evaluate the biological behavior and treatment method for the breast atypical lobular hyperplasia (ALH) and breast lobular carcinoma in situ (LCIS). METHODS: Seventeen cases of ALH and thirty-five cases of LCIS were reviewed from July 1982 to January 1996. All cases were followed by physical examination, mammography and B-ultrasound for an average of 146.6 months (range, 3 - 257 months). RESULTS: Most cases of ALH and LCIS occurred before menopause (about 69.2%). Fifty-two cases of ALH and LCIS were occasionally verified pathologically after surgery for benign diseases. The microcalcification with ALH and LCIS had been detected in 25 cases, accounted for 48.1%. Eight cases of ALH/LCIS became invasive carcinoma. There were 5 cases in the same breast, 3 cases in the contralateral breast; The subsequent breast cancer occurred longer than nine years after ALH/LCIS was diagnosed. The family history of breast carcinoma and ovary carcinoma occured in 4 cases of breast carcinoma, accounted for 50%, but it was no significant (P > 0.05). Also, there was no difference between LCIS and ALH, which occurred the breast carcinoma (P > 0.05). CONCLUSION: The excisional biopsy might be necessary to ALH and LCIS.