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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