Kim Janet H, Tavassoli Fattaneh, Haffty Bruce G
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA.
Cancer J. 2006 Mar-Apr;12(2):92-101.
Local chest wall relapse following mastectomy for ductal carcinoma in situ (DCIS) is an unusual event. We report on 10 cases of patients treated with mastectomy for DCIS who subsequently experienced a chest wall relapse as the first site of recurrence. To our knowledge, this is the largest reported collection of postmastectomy chest wall relapses for DCIS. The tumor registry and medical records from Yale-New Haven Hospital of all patients treated for ductal carcinoma in situ were reviewed. Individual records and radiation therapy charts of those patients sustaining a chest wall relapse following mastectomy were reviewed in detail. All pathology from the original mastectomy, as well as from the chest wall relapse, was re-reviewed by the pathologist. All chest wall relapses were treated with radiation therapy, with or without adjuvant systemic therapy. Of the 10 cases, 9 patients remain alive without evidence of disease. Young patient age, multiquadrant disease, and the presence of residual normal breast tissue were common features among these chest wall relapses. Pathological features of the original mastectomies and chest wall relapses are presented and discussed. Postmastectomy chest wall relapses in patients with DCIS are an uncommon event. Patients treated aggressively with resection of the lesion followed by radiation therapy to the chest wall have a favorable prognosis.
导管原位癌（DCIS）乳房切除术后局部胸壁复发是一种罕见事件。我们报告了10例接受DCIS乳房切除术的患者，这些患者随后出现胸壁复发作为首个复发部位。据我们所知，这是已报道的DCIS乳房切除术后胸壁复发病例的最大系列。回顾了耶鲁 - 纽黑文医院所有接受导管原位癌治疗患者的肿瘤登记和病历。对乳房切除术后出现胸壁复发的患者的个人记录和放射治疗图表进行了详细审查。病理学家对所有来自初始乳房切除术以及胸壁复发的病理切片进行了重新审查。所有胸壁复发均接受了放射治疗，部分患者还接受了或未接受辅助全身治疗。10例患者中，9例患者仍存活且无疾病证据。年轻患者年龄、多象限病变以及残留正常乳腺组织的存在是这些胸壁复发患者的常见特征。本文展示并讨论了初始乳房切除术和胸壁复发的病理特征。DCIS患者乳房切除术后胸壁复发是罕见事件。积极接受病变切除并随后对胸壁进行放射治疗的患者预后良好。
