探讨乳腺浸润性筛状癌(ICC)的临床病理特征及超声表现。

回顾性分析了2013年1月至2018年9月华中科技大学同济医学院附属同济医院治疗的8例乳腺ICC患者的临床资料。

8例乳腺ICC均为女性，中位年龄46岁(范围：26～81岁)，病理分型4例为单纯型，4例为混合型。6例无淋巴结转移，2例有淋巴结转移，均为2枚。7例ER及PR阳性，1例ER阳性、PR阴性。8例细胞增殖指数Ki67≤30%。术前超声诊断BI-RADS 4A级3例，4B级1例，4C级及5级4例。超声表现：所有病灶纵横比均>1，形态均不规则；6例边界尚清晰，2例边界不清晰；边缘光整2例，边缘毛刺、分叶或成角6例；8例均为低回声，其中4例后方回声增强，2例无变化，2例伴声衰减；3例伴有细小钙化；6例为点状及棒状血流信号，2例可见1～2条穿支血管，动脉阻力指数中位值为0.76。1例行保留乳房手术＋同侧腋窝淋巴结清扫，1例行左乳切除＋前哨淋巴结活组织检查，其余6例行乳腺癌改良根治术。8例患者术后均接受辅助化疗及内分泌治疗。术后随访3～48个月(中位随访10个月), 8例患者均无复发、转移及死亡。

乳腺ICC是一种预后较好的恶性肿瘤，单纯型ICC多表现良性结节的超声特征。乳腺科及超声医师应提高对该病的认识，降低误诊率，提高术前诊断率。

To explore the clinicopathological and ultrasonographic characteristics of breast invasive cribriform carcinoma (ICC).

We retrospectively analyzed the clinical data of 8 patients with breast ICC in Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2013 to September 2018.

All eight cases were female, with median age of 46 years (range: 26-81 years). There were four patients with simple ICC and four patients with mixed type. Six patients had no lymph node metastasis and the other two patients had the metastasis of two lymph nodes. Seven cases were ER-positive and PR-positive; one case was ER-positive and PR-negative. The cell proliferation index Ki67 was ≤30% in all eight cases. Preoperative ultrasound diagnosis revealed three cases of BI-RADS 4A, one case of BI-RADS 4B, and four cases of BI-RADS 4C and 5. Ultrasonic findings were as follow: aspect ratio >1 and irregular morphology in all lesions; clear border in six cases and unclear border in two cases; smooth edge in two cases, burred, lobular or angled edge in six cases; hypoechoic area in eight cases, including posterior echo enhancement in four cases, no change in two cases and sound attenuation in two cases; fine calcification in three cases; punctiform and rod-shape blood flow signals in six cases, one or two perforating vessels in two cases, median arterial resistance index of 0.75. One patient underwent breast conservative surgery and ipsilateral axillary lymph node dissection, one patient underwent left mastectomy and sentinel lymph node biopsy, and the other 6 patients underwent modified radical mastectomy. All patients received adjuvant chemotherapy and endocrine therapy after surgery. All patients were followed up for 3 to 48 months (median 10 months). During the follow-up, no recurrence, metastasis and death were observed in 8 cases.

Breast ICC is a malignant tumor with good prognosis. The patients with simple ICC usually present the ultrasonographic characteristics of benign nodules. The breast clinicians and ultrasound doctors should improve their awareness of this disease in order to reduce the rate of misdiagnosis and improve preoperative diagnosis rate.