大ㄋㄟㄋㄟ不是福 可能是這問題速就醫
2022-08-21 編輯部/台南報導
45歲的陳女士並無特殊疾病史,日前右邊乳房無故逐漸腫大,造成肩膀負擔,甚至到最後連內衣都穿不下去,最後前往柳營奇美醫院乳房外科門診求助,經檢查後發現有乳腺炎併乳房膿瘍症狀,粗針穿刺及斷層後確定是乳房葉狀瘤,採手術切除,目前身體狀況穩定並定期門診追蹤。
柳營奇美外科主治醫師王新富表示,乳房葉狀瘤類似一般的纖維腺瘤,會出現無痛性的乳房腫塊,約有1到3公分左右,部分生長迅速,可在幾個月內腫脹到20至30公分,好發於40到50多歲中年女性;臨床診斷上會以乳房X光攝影、乳房超音波、粗針穿刺得到初步結果,但此型態腫瘤有時類似纖維腺瘤,需透過手術切除後的細胞學檢查,才能得到正確病理診斷。
王新富說明,乳房葉狀瘤在病理分類上分為良性、惡性及邊緣型,比例上以良性居多,良性乳房葉狀瘤在臨床治療上以手術切除為主,除了移除葉狀瘤,還會切除1到2公分的正常乳房組織,如果巨大葉狀瘤已佔據乳房組織,就要實行全乳切除手術;良性葉狀瘤切除後,預後相當良好、復發率機率低,但手術後仍要持續追蹤,防範以惡性葉狀瘤的型態復發。
王新富指出,若屬惡性葉狀瘤,一般來說轉移機率較低,跟乳癌的治療方法不同,會以廣泛性切除為主,手術後若發現已轉移或為降低局部復發率,才會考慮化學治療、放射線治療。
王新富補充,政府提供45-69歲及40-44歲有乳癌家族史的婦女,每兩年1次免費乳房X光攝影檢查,如篩檢有問題,會轉診至醫院接受乳房超音波檢查,配合粗針穿刺及手術切片,甚至電腦斷層或磁振造影等做精準診斷。
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