乳癌疑雲：血液檢驗報告與病理報告分析-乳房甲狀腺科

乳癌疑惑？

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血液檢驗報告
Age: 40
科別:乳症科

檢驗名稱 結果值 參考值
W.B.C 4.91 4~10 10^3/uL
R.B.C 4.25 4~5.5 10^6/uL
Hb ↓ 11.4 12~16 g/dl
Hct ↓ 35.5 36~46 %
MCV 83.5 80~100 fL
MCH 26.8 26~34 pg
MCHC 32.1 31~37 g/dL
Platelet count 243 150~450 10^3/uL
Neutro 51.4 40~70 %
Lym 40.3 20~56 %
Mono 6.1 0~12 %
Eosin 1.6 0~5 %
Baso 0.6 0~2 %
A-Lym 0 %
Band 0 0~5 %
Metamyelo 0 %
Myelo 0 %
Pro 0 %
Blast 0 %
NRBC 0 /100WBC
APTT 27.7 23.9~34.9 s
Prothrom time 10.1;INR:0.98 8.7~11.9 s, INR

病理報告
25004C Surgical pathology Level IV [Malignancy]

DIAGNOSIS:
Breast, left, excisional biopsy --- Invasive ductal carcinoma

Immunostains:
HHF-35: loss of myoepithelial cells in tumor cells
P63: loss of myoepithelial cells in tumor cells
CK34bE12: focal positive
CK5/6: negative
E-cadherin: positive

GROSS DESCRIPTION:
The specimen submitted consisted of a piece of breast tissue measuring 2x 1.8 x1.7 cm in size, fixed in formalin.
Grossly, it appeared mildly firm in consistency and grayish in color.
Representative sections were taken.

MICROSCOPIC DESCRIPTION:
Microscopically, the sections show invasive ductal carcinoma, grade 3, with the neoplastic cells arranged in small solid sheets and infiltrating the stroma. High grade ductal carcinoma in situ characterized by solid growth pattern with comedo necrosis is present within the tumor. The surgical cut margin is not free of tumor.

恕本人愚昧，試問：
- 可以幫我解說一下內容嗎？謝謝
- 這樣的報告有瑕疵嗎？還是有什麼遺漏的部份？（在觸診時，醫師說應該是良性的，因為腫瘤表面平滑，摘取後應該就沒事了，然而，看到病理報告時，他覺得很訝異，跟當初的經驗判斷居然是相反的。心想這會不會是一場誤會？是驗錯？還是樣本調錯之類的程序問題呢？還是什麼狀況？非常困惑。有什麼複驗程序之類的嗎？）
- 如結果真如報告無誤，接下來的醫療程序是如何會較妥當呢？
- 醫師提到必須切除乳房，因為腫瘤離乳頭太近，試問，有其他解決方式不用切除嗎？
有太多無奈與焦慮...有需要其他資訊，可再行補充（有超音波照及攝影光碟）。感謝您的解答
敬祝閤家平安

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LiangRu，40~49歲女性，詢問日期：2010/02/21