Dillon Mary F, Hill Arnold D K, Fleming Fergal J, O'Doherty Ann, Quinn Cecily M, McDermott Enda W, O'Higgins Niall
Department of Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Am J Surg. 2006 Feb;191(2):201-5. doi: 10.1016/j.amjsurg.2005.03.041.
The association of invasive lobular carcinoma with high rates of compromised margins in breast conservation makes choice of operation for these patients difficult. We sought to identify patients at risk of compromised margins following breast conservation surgery.
We reviewed all patients with invasive lobular and invasive ductal carcinoma over a 5-year period (1999-2004). The imaging, pathology and surgical details of patients with invasive lobular carcinoma undergoing breast conservation were analyzed.
A total of 991 patients with invasive ductal carcinoma and 150 patients with invasive lobular carcinoma were identified. Lobular carcinomas had a compromised margin rate of 49% (n = 38/77) in breast conservation compared to 24% (n = 143/588) of ductal carcinomas (P < .0001). Mammographic size (P = .017), pathological size (P = .01), age (P = .03), multifocality (P < .0001), and lymphovascular invasion (P = .015) were significantly associated with compromised margins.
Invasive lobular carcinoma has a 49% rate of compromised margins following breast conservation. Mammographic size greater than 1.5 cm and young age were preoperative factors predictive of compromised margins.
浸润性小叶癌在保乳手术中切缘阳性率较高，这使得为这些患者选择手术方式变得困难。我们试图确定保乳手术后切缘阳性风险较高的患者。
我们回顾了5年期间（1999 - 2004年）所有浸润性小叶癌和浸润性导管癌患者。对接受保乳手术的浸润性小叶癌患者的影像学、病理学和手术细节进行了分析。
共确定了991例浸润性导管癌患者和150例浸润性小叶癌患者。保乳手术中，小叶癌的切缘阳性率为49%（n = 38/77），而导管癌为24%（n = 143/588）（P <.0001）。乳腺X线摄影测量大小（P =.017）、病理大小（P =.01）、年龄（P =.03）、多灶性（P <.0001）和淋巴管浸润（P =.015）与切缘阳性显著相关。
浸润性小叶癌保乳手术后切缘阳性率为49%。乳腺X线摄影测量大小大于1.5 cm和年轻是切缘阳性的术前预测因素。
