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早期浸润性乳腺癌或原位导管癌女性患者保乳术后放疗时乳腺磁共振成像与预后的关系

Relationship of breast magnetic resonance imaging to outcome after breast-conservation treatment with radiation for women with early-stage invasive breast carcinoma or ductal carcinoma in situ.

作者信息

Solin Lawrence J, Orel Susan G, Hwang Wei-Ting, Harris Eleanor E, Schnall Mitchell D

机构信息

Department of Radiation Oncology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.

出版信息

J Clin Oncol. 2008 Jan 20;26(3):386-91. doi: 10.1200/JCO.2006.09.5448.

Abstract

PURPOSE

To determine the relationship of breast magnetic resonance imaging (MRI) to outcome after breast-conservation treatment (BCT) with radiation for women with early-stage invasive breast carcinoma or ductal carcinoma in situ.

PATIENTS AND METHODS

A total of 756 women with early stage invasive breast carcinoma or ductal carcinoma in situ underwent BCT including definitive breast irradiation during 1992 to 2001. At the time of initial diagnosis and evaluation, routine breast imaging included conventional mammography. Of the 756 women, 215 women (28%) had also undergone a breast MRI study, and 541 women (72%) had not undergone a breast MRI study. The median follow-up after treatment was 4.6 years (range, 0.1 to 13.5 years).

RESULTS

For the women with a breast MRI study compared with the women without a breast MRI study, there were no differences in the 8-year rates of any local failure (3% v 4%, respectively; P = .51) or local-only first failure (3% v 4%, respectively; P = .32). There were also no differences between the two groups for the 8-year rates of overall survival (86% v 87%, respectively; P = .51), cause-specific survival (94% v 95%, respectively; P = .63), freedom from distant metastases (89% v 92%, respectively; P = .16), or contralateral breast cancer (6% v 6%, respectively; P = .39).

CONCLUSION

The use of a breast MRI study at the time of initial diagnosis and evaluation was not associated with an improvement in outcome after BCT with radiation.

摘要

目的

确定早期浸润性乳腺癌或导管原位癌女性患者在接受保乳治疗(BCT)并放疗后,乳腺磁共振成像(MRI)与治疗结果之间的关系。

患者与方法

1992年至2001年期间,共有756例早期浸润性乳腺癌或导管原位癌女性患者接受了BCT,包括确定性乳腺放疗。在初次诊断和评估时,常规乳腺成像包括传统乳腺X线摄影。在这756例女性患者中,215例(28%)还接受了乳腺MRI检查,541例(72%)未接受乳腺MRI检查。治疗后的中位随访时间为4.6年(范围0.1至13.5年)。

结果

与未进行乳腺MRI检查的女性相比,进行乳腺MRI检查的女性在8年的任何局部复发率(分别为3%和4%;P = 0.51)或仅局部首次复发率(分别为3%和4%;P = 0.32)方面没有差异。两组在8年总生存率(分别为86%和87%;P = 0.51)、特定病因生存率(分别为94%和95%;P = 0.63)、无远处转移生存率(分别为89%和92%;P = 0.16)或对侧乳腺癌发生率(分别为6%和6%;P = 0.39)方面也没有差异。

结论

在初次诊断和评估时使用乳腺MRI检查与BCT联合放疗后的治疗结果改善无关。

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