浸潤性乳腺小葉癌の臨床病理学的および診断学的検討 : その他の浸潤癌と比較して [in Japanese] CLINICOPATHOLOGICAL AND DIAGNOSTIC STUDIES OF INVASIVE LOBULAR CARCINOMAS COMPARED WITH OTHER INVASIVE CARCINOMAS OF THE BREAST [in Japanese]
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過去10年3カ月間に長野県がん検診センターの乳腺外来で診断した浸潤性小葉癌30例とその他の浸潤癌419例を臨床病理学的および診断学的に比較検討した.年齢的には浸潤性小葉癌の方がやや若い傾向がみられた.腫瘤の大きさ,病期などからみると,浸潤性小葉癌はその他の浸潤癌より進行例が多い印象を受けたが,リンパ節転移は陰性例が多かった.浸潤性小葉癌はその他の浸潤癌より触診で診断することが難しく, mammography より ultrasonography の方が有用であることが窺われた.穿刺吸引細胞診で悪性を疑った割合はその他の浸潤癌の94.2%に対して浸潤性小葉癌は75.0%と低かったが,他の診断法と比べると有意に高かった.また,穿刺感による診断も有用であることが示唆された.以上,乳腺疾患の診察に際しては,浸潤性小葉癌も念頭において,諸検査の他に穿刺感も参考にして診断することが有用であると考える.
Thirty female patients with invasive lobular carcinoma and 419 with other invasive carcinoma of the breast who were detected at the breast clinic of Nagano Cancer Center on an ambulant basis during the past 10 years and 3 months were retrospectively compared for clinicopathological and diangnostic factors.<br> The former group was a little younger in average age than the latter group. Judged from the tumor size, clinical stage and other factors, more advanced cases were involved in the former group than in the latter group. But the cases with lymph node metastasis were fewer in the former group than in the latter group.<br> Invasive lobular carcinomas presented difficulty in diagnossis by palpation compared to other invasive carcinomas. Ultrasonography was more useful than mammography to diagnose invasive lobular carcinoma as malignancy.<br> Diagnostic accuracy rate of invasive lobular carcinomas (75.0%) was statistically lower than that of other invasive carcinomas (94.2%) by aspiration biopsy cytology. But this rate was statistically higher than the rates of other diagnostic methods.<br> It was suggested that the feelings at needle insertion into invasive lobular carcinoma tissues were useful for malignant diagnosis.<br> From the above results, we would emphasize that we should keep a possible occurence invasive lobular carcinoma in mind and refer the feelings at needle insertion into tumorous tissues for the diagnosis of the mammary disorders.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 56(11), 2273-2278, 1995-11-25
Japan Surgical Association