Haffty B G, Kornguth P, Fischer D, Beinfield M, McKhann C
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06510.
Cancer. 1991 Jun 1;67(11):2801-4. doi: 10.1002/1097-0142(19910601)67:11<2801::aid-cncr2820671115>3.0.co;2-s.
At Yale-New Haven Hospital (New Haven, CT) treatment of early stage breast cancer with conservative surgery and radiation therapy (CS & RT) has been utilized with increasing frequency since the 1960s. The authors have reviewed their experience with specific reference to the outcome of those patients whose breast cancer was detected on routine screening mammography. To achieve adequate follow-up, only patients treated before December 1984 are included in this analysis. Of 438 patients treated with CS & RT before December 1984, a total of 41 patients (9%) had nonpalpable lesions detected on routine screening mammography and were treated with CS & RT to the intact breast. Only two patients received adjuvant hormonal therapy and no patients received adjuvant systemic therapy. There has been only one breast failure and one death due to cancer in this group of patients resulting in actuarial survival and breast recurrence-free rates of 100% at 5 years and 92% at 10 years. These results stress the importance of routine screening mammography and raise questions regarding the role of adjuvant systemic therapy in this selected group of patients.
自20世纪60年代以来，耶鲁-纽黑文医院（康涅狄格州纽黑文）采用保乳手术和放射治疗（CS & RT）治疗早期乳腺癌的频率越来越高。作者回顾了他们的经验，特别提及那些在常规乳腺钼靶筛查中发现乳腺癌的患者的治疗结果。为了进行充分的随访，本分析仅纳入1984年12月之前接受治疗的患者。在1984年12月之前接受CS & RT治疗的438例患者中，共有41例（9%）在常规乳腺钼靶筛查中发现不可触及的病变，并接受了对完整乳房的CS & RT治疗。只有2例患者接受了辅助激素治疗，没有患者接受辅助全身治疗。在这组患者中，仅有1例出现乳腺复发，1例死于癌症，5年实际生存率和无乳腺复发率为100%，10年为92%。这些结果强调了常规乳腺钼靶筛查的重要性，并引发了关于辅助全身治疗在这一特定患者群体中的作用的问题。
