Samuels J R, Haffty B G, Lee C H, Fischer D B
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06510.
Radiology. 1992 Nov;185(2):425-7. doi: 10.1148/radiology.185.2.1329142.
The authors reviewed their experience with 542 patients with breast cancer who were treated with conservative surgery and radiation therapy (CSRT) and analyzed the outcome in those patients whose tumors could not be detected with mammography. Fifty-five of the patients (10.1%) had a palpable, pathologically confirmed breast carcinoma and a negative preoperative mammogram. Routine follow-up included annual mammography and physical examination. The local recurrence, 5-year actuarial survival, and 5-year disease-free survival rates for these 55 patients did not differ significantly from those for patients with positive mammograms. There were six cases of local breast recurrence in this subgroup. Four of five cases were visible on mammograms (one patient did not undergo mammography at the time of recurrence); two of the cases were detected with mammography alone following physical examination with negative results. The authors conclude that patients with palpable but mammographically occult early-stage breast cancer are suitable candidates for CSRT and that mammography is a mandatory part of follow-up of conservatively treated patients.
作者回顾了542例接受保乳手术及放疗（CSRT）的乳腺癌患者的治疗经历，并分析了那些乳房X线摄影无法检测到肿瘤的患者的治疗结果。55例患者（10.1%）可触及经病理证实的乳腺癌，术前乳房X线摄影为阴性。常规随访包括每年的乳房X线摄影和体格检查。这55例患者的局部复发率、5年精算生存率和5年无病生存率与乳房X线摄影阳性的患者相比无显著差异。该亚组中有6例局部乳房复发。5例中有4例在乳房X线摄影中可见（1例患者在复发时未接受乳房X线摄影）；其中2例是在体格检查结果为阴性后仅通过乳房X线摄影检测到的。作者得出结论，可触及但乳房X线摄影隐匿的早期乳腺癌患者适合接受CSRT，乳房X线摄影是保乳治疗患者随访的必要组成部分。
