岳瑞雪 胡崇珠 冀雅铭 吴向东

[摘要]本文介绍了一例64岁女性乳腺黏液癌患者的基本情况，包括主诉、查体、辅助检查、诊断及治疗的过程、随访情况等。通过回顾乳腺黏液癌的相关文献，对乳腺黏液癌的定义、分型、临床表现、病理特征、诊断及鉴别诊断、治疗等方面进行复习，同时对乳腺癌前哨淋巴结微转移的相关文献进行复习，进而对第一部分所写病例的诊治过程进行分析和思考。通过复习相关文献，对此例前哨淋巴结微转移单纯型乳腺黏液癌的治疗情况进行分析总结，提高广大医师对此疾病的认识。

[关键词]前哨淋巴结;微转移;乳腺黏液癌;文献复习

[中图分类号] R737.9  [文献标识码] A   [文章编号]2095-0616（2021）24-0233-04

Sentinel lymph node micrometastasis simple mucinous carcinoma of breast： A case report and literature review

YUE  Ruixue1      HU  Chongzhu1      JI  Yaming2      WU  Xiangdong1

1.Department Ⅰ of Breast Surgery， Baoding No.1 Central Hospital， Hebei， Baoding 071000， China;2.Department of Pathology， Baoding No.1 Central Hospital， Hebei， Baoding 071000， China

[Abstract] This paper introduced the basic situation of a 64-year-old female patient with mucinous carcinoma of breast， covering chief complaint， physical examination， auxiliary examination， diagnosis and treatment process， follow-up， etc. The definition， classification， clinical manifestations， pathological features， diagnosis and differential diagnosis， treatment， etc. of mucinous carcinoma of breast were reviewed through a review of the relevant literature on mucinous carcinoma of breast， and the relevant literature on sentinel lymph node micrometastasis in breast cancer was reviewed， and then the diagnosis and treatment process of the case written in the first part was analyzed and considered. Through the review of the relevant literature and the analysis and summary of the treatment of this case of sentinel lymph node micrometastasis simple mucinous carcinoma of breast， the understanding of this disease among doctors could be improved.

[Key words] Sentinel lymph node;Micrometastasis;Mucinous carcinoma of breast;Literature review

乳腺黏液癌是浸润性特殊类型乳腺癌的一种，分为单纯型和混合型，单纯型黏液癌又分为少细胞型和富于细胞型。少细胞型黏液癌较少出现转移，而富于细胞型及混合型黏液癌淋巴结转移相对多见，混合型黏液癌淋巴结转移多为黏液癌之外的其他类型的癌转移[1-2]。单纯型乳腺黏液癌伴淋巴结微转移报道较少，而目前对于前哨淋巴结（sentinel lymph node， SLN）微转移的治疗尚存在争论。主要争论围绕在不进行腋窝淋巴结清扫的情况下是否会影响预后，以及是否所有的淋巴结微转移患者都需要进行全身辅助治疗这两个方面。目前的循证医学证据证实 SLN 微转移是独立的预后指标，有效的全身治疗显著改善了 SLN 微转移患者的无病生存率，针对全乳切除的 SLN 微转移患者能否避免腋窝淋巴结清扫应结合患者年龄、合并疾病、患者意愿、肿瘤生物学行为等综合考虑[3-5]。……