Takehara Megumi, Tamura Motoshi, Kameda Hiroshi, Ogita Masami
Department of Breast Surgery, National Sapporo Hospital, 4-2 Kikusui, Shiroishi-ku, Sapporo, Hokkaido 003-0804, Japan.
Breast Cancer. 2004;11(1):69-72. doi: 10.1007/BF02968006.
Experience with conserving surgery for lobular carcinoma has grown as more breast conserving surgeries have been performed. We examined the results of breast conserving therapy in lobular carcinoma.
We examined the postoperative positive margin rate, presence or absence of additional surgery, presence or absence of local or systemic recurrence and role of breast helical CT in 25 cases of breast conserving surgery performed at this department from 1991 through June 2003.
Among the 303 cases of all breast conserving surgeries, there were 63 case with positive margins (20.8%), but there were 15 of 25 positive margin cases (60.0%) among the lobular carcinoma cases. In 8 of the 15 positive margin cases the technique was changed to mastectomy. One case of recurrence in the breast has been observed thus far. Although the positive margin rate and positive margin rate in infiltrating carcinoma cases tended to decline after the introduction of breast helical CT, the rates remained high.
Since the positive margin rate was significantly high at the time of breast conserving surgery for lobular carcinoma, careful selection of technique based on imaging studies such as breast helical CT and MRI along with careful follow-up is considered necessary.
随着更多保乳手术的开展，小叶癌保乳手术的经验也有所增加。我们研究了小叶癌保乳治疗的结果。
我们研究了1991年至2003年6月在本科进行的25例保乳手术的术后切缘阳性率、是否需要二次手术、是否存在局部或全身复发以及乳腺螺旋CT的作用。
在所有保乳手术的303例患者中，有63例切缘阳性（20.8%），但在小叶癌病例的25例切缘阳性患者中有15例（60.0%）。在15例切缘阳性病例中的8例，手术方式改为乳房切除术。迄今为止，观察到1例乳腺复发。虽然引入乳腺螺旋CT后浸润性癌病例的切缘阳性率和阳性切缘率有下降趋势，但仍维持在较高水平。
由于小叶癌保乳手术时切缘阳性率显著较高，因此认为有必要基于乳腺螺旋CT和MRI等影像学检查仔细选择手术方式，并进行密切随访。
