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乳腺浸润前疾病的诊断与管理：与浸润前病变管理相关的问题。

The diagnosis and management of pre-invasive breast disease: problems associated with management of pre-invasive lesions.

作者信息

Purushotham Anand D

机构信息

Cambridge Breast Unit, Addenbrooke's NHS Trust, Cambridge, UK.

出版信息

Breast Cancer Res. 2003;5(6):309-12. doi: 10.1186/bcr649. Epub 2003 Oct 9.

DOI:10.1186/bcr649
PMID:14580248
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC314409/
Abstract

The treatment of ductal carcinoma in situ (DCIS) involves adequate surgical excision with adjuvant radiotherapy where appropriate. An inadequate excision margin and young age are independent risk factors for local recurrence. Routine surgery to axillary lymph nodes is not recommended in pure DCIS. In localised DCIS, adjuvant radiotherapy is recommended on the basis of tumour size, margin width and pathological subtypes. The role of adjuvant tamoxifen as systemic therapy is controversial. The treatment of atypical ductal/lobular hyperplasia and lobular carcinoma in situ involves surgical excision to exclude coexisting DCIS or invasive disease.

摘要

导管原位癌（DCIS）的治疗包括在适当情况下进行充分的手术切除并辅以放疗。切缘不充分和年轻是局部复发的独立危险因素。对于单纯DCIS，不建议常规进行腋窝淋巴结手术。在局限性DCIS中，根据肿瘤大小、切缘宽度和病理亚型推荐辅助放疗。辅助他莫昔芬作为全身治疗的作用存在争议。非典型导管/小叶增生和小叶原位癌的治疗包括手术切除以排除并存的DCIS或浸润性疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9969/314409/735325f672f9/bcr649-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9969/314409/558ee9ca9518/bcr649-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9969/314409/735325f672f9/bcr649-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9969/314409/558ee9ca9518/bcr649-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9969/314409/735325f672f9/bcr649-2.jpg

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本文引用的文献

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Lancet. 2002 Sep 14;360(9336):817-24. doi: 10.1016/s0140-6736(02)09962-2.
2
Effects of patient selection on the applicability of results from a randomised clinical trial (EORTC 10853) investigating breast-conserving therapy for DCIS.患者选择对一项关于导管原位癌保乳治疗的随机临床试验（EORTC 10853）结果适用性的影响。
Br J Cancer. 2002 Sep 9;87(6):615-20. doi: 10.1038/sj.bjc.6600514.
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Nonmalignant lesions in breast core needle biopsies: to excise or not to excise?
Breast Cancer Res. 2004;6(1):E3; discussion E4. doi: 10.1186/bcr740.
4
The diagnosis and management of pre-invasive breast disease--current challenges, future hopes.乳腺疾病癌前病变的诊断与管理——当前挑战与未来希望
Breast Cancer Res. 2003;5(5):248-9. doi: 10.1186/bcr641. Epub 2003 Jul 28.
乳腺粗针穿刺活检中的非恶性病变：切除还是不切除？
Am J Surg Pathol. 2002 Sep;26(9):1095-110. doi: 10.1097/00000478-200209000-00001.
4
Breast-conserving therapy for ductal carcinoma in situ of the breast: the French Cancer Centers' experience.乳腺导管原位癌的保乳治疗：法国癌症中心的经验。
Int J Radiat Oncol Biol Phys. 2002 Jul 15;53(4):868-79. doi: 10.1016/s0360-3016(02)02834-1.
5
Age at diagnosis and outcome for women with ductal carcinoma-in-situ of the breast: a critical review of the literature.乳腺导管原位癌女性患者的诊断年龄与预后：文献综述
J Clin Oncol. 2002 Jun 1;20(11):2736-44. doi: 10.1200/JCO.2002.07.137.
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Excisional biopsy should be performed if lobular carcinoma in situ is seen on needle core biopsy.如果在粗针活检中发现小叶原位癌，则应进行切除活检。
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