예후가 좋은 조직학적 유형의 유방암 -수질암, 점액상암, 유두상암 및 관상암의 임상적 고찰-
Clinical Analysis of the Favorable Type of Breast Cancer -Medullary, Mucinous, Papillary and Tubular Carcinoma-
소속 상세정보
전창완/Chang Wan Jeon
노우철/문난모/백남선/이종인/최동욱/방호윤/Woo Chul Noh/Nan Mo Moon/Nam Sun Paik/Jong Inn Lee/Dong Wook Choi/Ho Yoon Bang
KMID : 0360319990310010082
Abstract
서론
일반적인 침윤성 유방암에 비하여 좋은 예후를 보이는 것으로 알려져, 조직학적 분류상
예후가 좋은 유형(favorable type)으로 분류되는 수질암(medullary carcinoma), 점액상암
(mucinous carcinoma), 유두상암(papillary carcinoma), 관상암(tubular carcinoma)은 흔하지
않은 암종으로 전체 유방암의 각각 2.0∼8.0%(1,8∼12), 1.0∼2.0%(13), 0.3∼3.0%(14), 2.0%
이하를 차지한다. 우리나라의 경우 충분한 증례수를 포함한 이들 종양에 대한 장기추적결과
는 거의 없는 실정이다. 따라서 저자들은 1987년 1월부터 1997년 12월까지 만11년간 원자력
병원 외과에서 치료한 유방암 환자 2,961명 중 조직학적적 분류상 예후가 좋은 유형으로 구
분되는 수질암, 점액상암, 유두상암, 관상암으로 진단받고 치료한 83예에 대한 임상 분석을
시행하여 결과를 문헌 고찰과 함께 보고하는 바이다.
Purpose: The favorable types of the breast cancer - medullary, mucinous, papillary
and tubular carcinoma are uncommon subtypes and their incidences in different series
ranges between 2.0% and 8.0%, 1% and 2%, 0.3% and 3%, less than 2% of all breast
cancers, respectively. In western countries these subtypes have been reported to have
good prognosis and slow growth rate. Clinically, these tumors have lower frequency of
axillary nodal involvement and better 5-year or 10-year surviral rate than the other
common types of breast cancer.
Materials and Methods: To determine the clinical charactcristics and to evaluate the
correlation between the progrostic factors and survival rate of these tumors, the medical
records of 83 women with medullary, mucinous, papillary and tubular carcinoma treated
at Korea Cancer Center Hospital between Jan. 1987 and Dec. 1997 were reviewed
retrospectively.
Results: The incidences of medullary, mucinous, papillary and tubular carcinoma were
0.51%, 1.45%, 0.71% and 0.14% of all breast cancer, respectively. There were 1 case of
local recurrence and 5 cases of systemic relapse during the follow-up (median follow-up
peroid of 56 months). Overall 5-year survival and 10-year survival rate were 98.5% and
94.2%, respectively. No significant difference in overall survival rate was detected
according to histologic types of these tumors but disease-free survival was significantly
lower in papillary carcinoma than the other types of these tumors (p=0.042). Standard
prognostic factors of breast cancer such as tumor size, lymph node status, age of the
patient and ER status did not affect the prognosis of these tumors.
Conclusion: Medullary, mucinous, papillary and tubular carcinoma revealed very
excellent prognosis in this study regardless of tumor size, lymph node status, age of the
patients and ER status.
키워드
Breast cancer; Favorable type; Prognosis;
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