Yan Jiayu,Peng Chunhui,Cheng Haiyan,et al.Clinical features and outcomes of excised breast masses in children[J].Journal of Clinical Pediatric Surgery,2024,(05):458-463.[doi:10.3760/cma.j.cn101785-202111031-011]
儿童切除乳房肿物的临床特点及预后分析
- Title:
- Clinical features and outcomes of excised breast masses in children
- Keywords:
- Breast Mass; Pathologic Type; Prognosis; Surgical Procedures; Operative; Child
- 摘要:
- 目的 探讨儿童切除乳房肿物的临床特点及预后。 方法 回顾性收集2010年1月至2021年5月于首都医科大学附属北京儿童医院行乳房手术并经病理检查确诊为乳房肿物的34例患儿临床资料,分析女性患儿(n=28)与男性患儿(n=6)的一般情况、病理特征和影像学特点,并通过收集门诊复查资料或电话的形式随访预后。 结果 女性患儿就诊年龄(12.1±2.0)岁,以可触及乳房肿块(28/28,100%)和外观异常(6/28,21.4%)为主要症状,出现症状时间为3.00(0.25~60.00)个月,术前检查主要为超声检查(27/28,96.4%)和胸部CT(13/28,46.4%)。女性患儿均行乳房肿物切除术,主要入路为乳房边缘弧形切口(10/28,35.7%)和乳晕弧形切口(9/28,32.1%);切除的肿物均为良性,主要为纤维腺瘤(23/28,82.1%),术前超声检查诊断纤维腺瘤的灵敏度为90.9%(20/22)。男性患儿就诊年龄(4.5±4.2)岁,主要症状为可触及乳房肿块(6/6,100%)和外观异常(2/6,33.3%);4例良性肿瘤行乳房肿物切除术,1例分泌性乳腺癌和1例胸壁滑膜肉瘤分别行乳腺癌局部扩大切除术和胸壁肿瘤切除术。共29例(29/34,85.3%)患儿获得随访,女24例、男5例。女性患儿中,20例为纤维腺瘤,其中2例复发(2/20,10%),1例(1/20,5.0%)残留,1例(1/20,5.0%)对侧乳房出现肿物;其余4例女性乳房肿物患儿预后良好。5例男性乳房肿物患儿中,男性胸壁滑膜肉瘤术后接受放化疗,目前恢复良好;其余4例均预后良好。 结论 女性患儿乳房肿物以纤维腺瘤为主,超声检查能辅助术前诊断,但需警惕残留、复发;男性患儿乳房肿物的发病年龄相对较小,需考虑恶性肿瘤可能。儿童乳房肿物完整切除预后良好。
- Abstract:
- Objective To explore the clinical features and outcomes of excised breast masses in children.Methods From January 2010 to May 2021,retrospective review was conducted for 34 children undergoing breast mass excision.There were 6 boys and 28 girls.The outcomes were followed up by outpatient visits or telephone interviews.Results Mean age in girls was (12.1±2.0) years with primary symptoms of palpable breast mass (28/28,100%) and abnormal appearance (6/28,21.4%).The average duration of symptoms was 3.00(0.25-60.00) months.Two major preoperative examinations were ultrasonography (27/28,96.4%) and computed tomography (13/28,46.4%).Periareolar incision (10/28,35.7%) and perimammary incision (9/28,32.1%) were performed.All excised masses in girls were benign with a predominance of fibroadenoma (23/28,82.1%).The sensitivity of preoperative ultrasonography for diagnosing fibroadenoma was 90.9%(20/22).Mean age in boys was (4.5±4.2) years with the same primary symptoms of palpable breast mass (6/6,100%) and abnormal appearance (2/6,33.3%).Breast mass resection was performed for benign tumors (n=4) and mastectomy and chest wall tumor resection for with secretory breast carcinoma and synoviosarcoma in chest wall (n=2).Twenty-nine children (29/34,85.3%) were followed up.Among girls with fibroadenomas,2(2/20,10.0%) had recurrence,1(1/20,5.0%) had postoperative residue and 1(1/20,5.0%) presented with a mass in contralateral breast.One boy with synoviosarcoma received postoperative radiochemotherapy and recovered well.The remainders had a decent prognosis.Conclusions Fibroadenoma is a major pathologic type in girls with breast mass.Ultrasound may assist in preoperative diagnosis.It is necessary to watch for postoperative residue and recurrence.The age of boys with breast mass is often young and the possibility of malignant tumor should be considered.The prognosis in children is decent after a complete resection of breast mass.
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备注/Memo
收稿日期:2021-11-16。
通讯作者:王焕民,Email:wanghuanmin@bch.com.cn;陈亚军,Email:chenyajunmd@aliyun.com