KẾT QUẢ PHẪU THUẬT UNG THƯ VÚ KHÔNG SỜ THẤY TRÊN LÂM SÀNG TẠI BỆNH VIỆN K

Abstract

Purpose: Clinical characteristics, work-ups and outcomes of surgery in non-palpable breast cancer. Methods: Description of a retrospective case series of patients diagnosed with clinically non-palpable breast cancer. Patients then were treated with modified or conservative radical mastectomy with axillary lymph node dissection at K Hospital from January 2018 to June 2023. Results: Among 55 patients in the study, there were 28 cases diagnosed as in situ and 27 cases were invasive cancer. The most common reason for hospitalization was a routine health check-up to detect breast tumors, accounting for 46/55 cases. The average body mass index of the study group was 22.0, the smallest was 18.8 and the largest was 25.0. Among patients with in situ breast cancer, the average tumor size was 1.07cm. There were 8 cases of non-massive tumors, which tumor size could not be determined. Among 27 patients with invasive tumors, the average tumor size was 1.1cm, the smallest one was 0.3cm and the largest one was 3.0cm. The number of conservative surgical procedures accounts for 16.4% (9/55 cases). The average number of lymph nodes removed in the study was 10.0, the largest number of lymph nodes removed was 20 and there were 2 cases when surgeons only examined axillary lymph nodes. Of these, 2/55 cases metastasized to axillary lymph nodes, accounting for 3.6%, both of which metastasized to 1 lymph node. Postoperative stage: stage 0 accounts for 50.9%, stage I accounts for 41.8%, stage II accounts for 7.3%. The only early complication in this study was surgical wound seroma, accounting for 7.3% (4/55 cases). No complications of lymphedema were encountered in the study. The main adjuvant treatment after surgery is endocrine treatment in 28/55 cases, accounting for 50.9%. Conclusion: Breast cancer that can not be examined clinically is often detected through routine health examinations when there are no clinical signs. About 50% of cases are in situ, non-invasive cancers. Most invasive cancer cases are in stage T1. The rate of conservative surgery is higher, the rate of axillary lymph node metastasis is very low and postoperative complications are very rare, only complications of seroma occur and can be resolved by fluid aspiration. Adjuvant treatment after surgery is mainly endocrine treatment, and in many cases no treatment is even needed. Recommendation: It is necessary to raise awareness and widely disseminate the Breast Cancer screening program through screening mammography to detect lesions that are not yet palpable clinically. This will reduce the stage and improve the quality of treatment as well as the prognosis of breast cancer.