乳腺导管原位癌患者保乳术后切缘宽度作为局部复发的唯一决定因素。
Margin width as the sole determinant of local recurrence after breast conservation in patients with ductal carcinoma in situ of the breast.
作者信息
Macdonald Heather R, Silverstein Melvin J, Lee Laura A, Ye Wei, Sanghavi Premal, Holmes Dennis R, Silberman Howard, Lagios Michael
机构信息
USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave., Room 7415, Los Angeles, CA 90033-0800, USA.
出版信息
Am J Surg. 2006 Oct;192(4):420-2. doi: 10.1016/j.amjsurg.2006.06.031.
BACKGROUND
A previous study showed a 3% local recurrence risk at 8 years in ductal carcinoma in situ (DCIS) patients treated with excision alone with surgical margins of 10 mm or greater. This study updates those data.
METHODS
A total of 272 DCIS patients treated conservatively with 10 mm or greater margins were reviewed in a prospective database.
RESULTS
Among 212 excision-alone patients, there were 9 DCIS and 3 invasive recurrences. The 12-year probability of any local recurrence was 13.9%; of invasive recurrence it was 3.4%. Among 60 excision plus radiation patients, there was 1 local (invasive) recurrence (P = .06). The 12-year probability of local recurrence was 2.5%.
CONCLUSIONS
Local recurrence in DCIS patients treated with excision alone with margins of 10 mm or greater compares favorably with local recurrence in DCIS patients with nontransected margins and treated with postoperative radiation. The risk of invasive recurrence among widely excised DCIS patients is extremely low.
背景
先前的一项研究表明，仅接受手术切除且手术切缘为10毫米或更大的导管原位癌（DCIS）患者在8年时的局部复发风险为3%。本研究更新了这些数据。
方法
在一个前瞻性数据库中对272例接受保守治疗且切缘为10毫米或更大的DCIS患者进行了回顾。
结果
在212例仅接受切除的患者中，有9例DCIS复发和3例浸润性复发。任何局部复发的12年概率为13.9%；浸润性复发的概率为3.4%。在60例切除加放疗的患者中，有1例局部（浸润性）复发（P = 0.06）。局部复发的12年概率为2.5%。
结论
仅接受手术切除且切缘为10毫米或更大的DCIS患者的局部复发情况优于切缘未切断且接受术后放疗的DCIS患者。广泛切除的DCIS患者发生浸润性复发的风险极低。
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