Hepp R, Baeza M R
Instituto de Radiomedicina IRAM, Santiago de Chile.
Rev Med Chil. 1999 Nov;127(11):1345-50.
Since the widespread use of mammography, the incidence of ductal carcinoma in situ of the breast has increased. Until few years ago the standard treatment was mastectomy, however, from the analysis of conservative treatment trials for invasive carcinoma, it was evident that ductal carcinoma in situ could also be treated conservatively. This was confirmed later by randomized trials.
To analyze the experience of our Institution with conservative treatment of ductal carcinoma in situ of the breast.
A search through the data base of our Institution found 69 patients treated with lumpectomy and radiotherapy between the years 1976 and 1997.
Twenty three of 69 patients (33%) were diagnosed because of a palpable mass. Eleven of twelve were diagnosed prior to 1990 and 12 of 57 after 1990. With a median follow-up of 48 months local control and overall survival is 97%. None of the patients underwent mastectomy.
Conservative treatment of ductal carcinoma in situ of the breast is a reasonable alternative, mainly if we realize that with increasing frequency--the diagnosis is made through mammography and with non-palpable lesions. The results reported in this study are similar to those reported by other centers.
自从乳房X线摄影广泛应用以来,乳腺导管原位癌的发病率有所上升。直到几年前,标准治疗方法还是乳房切除术,然而,通过对浸润性癌保守治疗试验的分析,很明显导管原位癌也可以采用保守治疗。这一点后来得到了随机试验的证实。
分析我院对乳腺导管原位癌进行保守治疗的经验。
通过我院数据库检索,发现1976年至1997年间有69例患者接受了肿块切除术和放射治疗。
69例患者中有23例(33%)因可触及肿块而被诊断。12例中有11例在1990年之前被诊断,57例中有12例在1990年之后被诊断。中位随访48个月,局部控制率和总生存率为97%。没有患者接受乳房切除术。
乳腺导管原位癌的保守治疗是一种合理的选择,尤其是当我们意识到越来越频繁地通过乳房X线摄影诊断出不可触及的病变时。本研究报告的结果与其他中心报告的结果相似。