不好意思, 剛剛有發問過, 我直接把報告貼上~~~奶奶最

發問日期	2012年10月17日
問題內容	不好意思, 剛剛有發問過, 我直接把報告貼上~~~奶奶最近得了乳癌二期(stageIIA) pT2 Nx, 我們都很擔心, 她己經快80歲了, 己聽醫生建議先切除乳房, 醫生並不建議化療, (因為年紀的關係), 並告知可以吃藥控制, 真的是這樣嗎? (她7年前心臟有開刀), 可否使用健保的標靶藥物? 以下是她的切片報告,可以幫忙翻譯嗎?我想知道到底她的二期是否有擴散?醫生的建議真的沒錯嗎? 奶奶是在雲林一家醫院手術的, 老實說設備等等好像沒有北部的好, 想再問問專家的意見: Breast, right, excisional biopsy---Invasive carcinoma of no special type(former invasive ductal carcinoma) Tentative pathologic stage IIA(pT2 Nx) The specimen submitted consists of an excision of right breast. It measures 8.3x4.5x3.3cm. It is covered by an ellipse of skin, which measures 7.5x 2.8cm, fixed in formalin. On cut, there is a whitish and firm lesion measuring 2.7x1.0x0.7cm just below the skin tissue. Another firm lesion measuring 2.5x2.2x1.0cm is noted 0.3cm below the subcutaneous lesion. After serial cut, there is connection between these two lesions. The shortest distance from the lesions to resection margin measures 0.1cm. Gossly, it is Representative sections are taken and labeled as 1-5. Microscopically, Procedure: excision without wire-guided localization Lymph Node Sampling: not performed Specimen Laterality: right Histologic Type of Invasive Carcinoma:Invasive carcinoma of no special type(former invasive ductal carcinoma) Tumor Size/Size of Largest Invasive Carcinoma: Greatest dimension of largest focus of invasion: 3.7cm, microscopically Histologic Grade: Nottingham Histologic Score(Note F) Glandular(Acinar)/Tubular Differentiation Score 3: 20mm but <50mm in greatest dimension Regional Lymph Nodes (pN) pNX: Regional Lymph nodes cannot be assessed Distant Metastasis(pM)

回答醫師	謝瑞坤
回答日期	2012年10月17日
回答內容	目前病理報告只確定: 1. 乳癌, 2. 第二A期 (至少) pT2NxMx, 至於是否擴散?? 另需"淋巴結切除與病理報告才能決定N? , 另需:全身電腦斷層與骨骼掃描才能決定M? 上述書面無相關資料, 所以NxMx。雲嘉南地區有多所國立大學附醫與分院, 腫瘤醫療水準都很不錯, 是醫療可近性的好選擇。