PDF(Pubmed)
Abstract：
UNASSIGNED: Due to its indolent biology and high estrogen receptor positivity of mucinous breast cancer, vast majority of locally advanced mucinous breast cancer (LABC) are treated with first-line endocrine therapy.
UNASSIGNED: A 50-year-old woman was referred to our hospital for the treatment of her huge breast tumor. Computed tomography showed an oval solid tumor, 17 cm in size, and lymph node swelling in both the axilla and parasternum. Pathological study of the core needle biopsy specimen showed the tumor to be luminal mucinous carcinoma. After the failure of endocrine therapy aiming for tumor regression, the patient received sequential chemotherapy to get favorable local control, leading to marked tumor shrinkage. Axillar and parasternal lymph nodes, however, remained unchanged in size. The patient further underwent mastectomy and regional lymph node dissection including removal of the still enlarged parasternal lymph nodes followed by covering of the large skin defect with the latissimus dorsi musculocutaneous (LDMC) flap using a spindle skin island, 15 × 8 cm in size. Postoperative pathological study showed sparse cancer cell remnants with abundant mucus in both the primary tumor and the dissected lymph nodes. The patient has been well without any recurrences on endocrine therapy for 21 months.
UNASSIGNED: Breast oncologists should note that multidisciplinary treatment including preoperative chemotherapy and skin defect covering using LDMC flap can give favorable local control even to breast cancer patients with LABC.
UNASSIGNED: A 50-year-old woman was referred to our hospital for the treatment of her huge breast tumor. Computed tomography showed an oval solid tumor, 17 cm in size, and lymph node swelling in both the axilla and parasternum. Pathological study of the core needle biopsy specimen showed the tumor to be luminal mucinous carcinoma. After the failure of endocrine therapy aiming for tumor regression, the patient received sequential chemotherapy to get favorable local control, leading to marked tumor shrinkage. Axillar and parasternal lymph nodes, however, remained unchanged in size. The patient further underwent mastectomy and regional lymph node dissection including removal of the still enlarged parasternal lymph nodes followed by covering of the large skin defect with the latissimus dorsi musculocutaneous (LDMC) flap using a spindle skin island, 15 × 8 cm in size. Postoperative pathological study showed sparse cancer cell remnants with abundant mucus in both the primary tumor and the dissected lymph nodes. The patient has been well without any recurrences on endocrine therapy for 21 months.
UNASSIGNED: Breast oncologists should note that multidisciplinary treatment including preoperative chemotherapy and skin defect covering using LDMC flap can give favorable local control even to breast cancer patients with LABC.
摘要：
■由于粘液性乳腺癌的惰性生物学和高雌激素受体阳性，绝大多数局部晚期黏液性乳腺癌(LABC)采用一线内分泌治疗.
■一名50岁的妇女被转诊到我们医院治疗她的巨大乳腺肿瘤。计算机断层扫描显示为椭圆形实体瘤，17厘米大小，腋窝和胸腹旁淋巴结肿大。核心针活检标本的病理研究显示肿瘤为管腔黏液癌。在针对肿瘤消退的内分泌治疗失败后，患者接受序贯化疗以获得良好的局部控制，导致肿瘤明显缩小.腋窝和胸骨旁淋巴结，然而,大小保持不变。患者进一步接受了乳房切除术和区域淋巴结清扫术，包括切除仍然扩大的胸骨旁淋巴结，然后使用纺锤形皮肤岛用背阔肌肌皮瓣（LDMC）覆盖大皮肤缺损，尺寸为15×8厘米。术后病理研究显示，在原发肿瘤和解剖的淋巴结中均有稀疏的癌细胞残留物，粘液丰富。患者接受内分泌治疗21个月，没有任何复发。
乳腺肿瘤学家应注意，包括术前化疗和使用LDMC皮瓣覆盖皮肤缺损在内的多学科治疗即使对LABC的乳腺癌患者也能给予良好的局部控制。
■一名50岁的妇女被转诊到我们医院治疗她的巨大乳腺肿瘤。计算机断层扫描显示为椭圆形实体瘤，17厘米大小，腋窝和胸腹旁淋巴结肿大。核心针活检标本的病理研究显示肿瘤为管腔黏液癌。在针对肿瘤消退的内分泌治疗失败后，患者接受序贯化疗以获得良好的局部控制，导致肿瘤明显缩小.腋窝和胸骨旁淋巴结，然而,大小保持不变。患者进一步接受了乳房切除术和区域淋巴结清扫术，包括切除仍然扩大的胸骨旁淋巴结，然后使用纺锤形皮肤岛用背阔肌肌皮瓣（LDMC）覆盖大皮肤缺损，尺寸为15×8厘米。术后病理研究显示，在原发肿瘤和解剖的淋巴结中均有稀疏的癌细胞残留物，粘液丰富。患者接受内分泌治疗21个月，没有任何复发。
乳腺肿瘤学家应注意，包括术前化疗和使用LDMC皮瓣覆盖皮肤缺损在内的多学科治疗即使对LABC的乳腺癌患者也能给予良好的局部控制。
