Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Breast J. 2009 Nov-Dec;15(6):649-52. doi: 10.1111/j.1524-4741.2009.00838.x.
Management of ductal carcinoma in situ (DCIS) of the breast is controversial, as not all patients progress to invasive carcinoma. This report analyzes the outcomes after breast conservation treatment (BCT) with radiation in patients with DCIS following prior malignancy at another anatomic site. The study cohort was comprised of 14 women with DCIS who were treated between 1978 and 2003. The median age at diagnosis of DCIS was 54 years (mean 56; range 37-78) and for the prior nonbreast malignancy was 44 years (mean 47; range 27-76). All patients underwent breast conservation surgery followed by whole breast radiation and tumor bed boost. The median and mean follow-up times after treatment of DCIS were 8.0 and 9.1 years, respectively (range 2-18). The median and mean interval period between the prior malignancy and DCIS was 6.0 and 8.2 years, respectively (range 1-30). There was one (7%) local failure, two (14%) contralateral breast cancers, and one (7%) death from breast cancer that occurred 7 years after BCT following contralateral invasive breast cancer. In this cohort of 14 patients treated for DCIS of the breast after a prior nonbreast malignancy, treatment for DCIS resulted in a high rate of local control and should be considered for curative intent.
乳腺导管原位癌(DCIS)的治疗存在争议,因为并非所有患者都会进展为浸润性癌。本报告分析了在另一个解剖部位存在先前恶性肿瘤的情况下,接受保乳治疗(BCT)加放疗的 DCIS 患者的结局。研究队列包括 14 名 DCIS 患者,他们于 1978 年至 2003 年期间接受治疗。DCIS 的中位诊断年龄为 54 岁(平均 56 岁;范围 37-78),而先前非乳腺恶性肿瘤的中位诊断年龄为 44 岁(平均 47 岁;范围 27-76)。所有患者均接受保乳手术,随后接受全乳腺放疗和肿瘤床加量放疗。治疗 DCIS 后的中位和平均随访时间分别为 8.0 年和 9.1 年(范围 2-18)。先前恶性肿瘤和 DCIS 之间的中位和平均间隔时间分别为 6.0 年和 8.2 年(范围 1-30)。有 1 例(7%)局部复发,2 例(14%)对侧乳腺癌,1 例(7%)死于乳腺癌,发生于对侧浸润性乳腺癌 BCT 后 7 年。在这组 14 例先前患有非乳腺恶性肿瘤的患者中,接受 DCIS 治疗后局部控制率很高,应考虑作为治愈性治疗。