Department of Breast Surgical Oncology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan.
Breast Cancer. 2012 Apr;19(2):131-7. doi: 10.1007/s12282-010-0218-5. Epub 2010 Aug 21.
It is very important to excise ductal carcinoma in situ (DCIS) with sufficient margins to prevent local recurrence. We describe the experience of ultrasonography (US)-guided and/or mammography (MMG)-guided breast conserving surgery (BCS) for DCIS.
In this retrospective study, we considered 87 consecutive lesions of 86 patients treated with US- and/or MMG-guided BCS between January and December 2006.
The mean age of the 86 patients was 50.0 years (range 28-80 years). Preoperative mapping was performed using US alone for 49 lesions without microcalcifications and using US and MMG for 38 lesions with microcalcifications. Eighty-one (93.1%) of the 87 lesions were diagnosed as non-comedo type or mixed type, and 6 lesions (6.9%) were diagnosed as comedo type of DCIS. Sixty-five lesions (74.8%) were diagnosed as negative margins, 15 lesions (17.2%) as close margins, and 7 lesions (8.0%) as positive margins. Three lesions (3.4%) without microcalcifications that were mapped using US alone underwent additional resection in a second operation. The maximum tumor size was correlated with margin status (p = 0.043).
Thus US- and/or MMG-guided BCS is a reliable method for treating patients with DCIS regardless of histopathological type and offers the advantage of being noninvasive and nonstressful for patients.
为了防止局部复发,切除足够边缘的导管原位癌(DCIS)非常重要。我们描述了超声(US)引导和/或乳房 X 线摄影(MMG)引导下保乳手术(BCS)治疗 DCIS 的经验。
在这项回顾性研究中,我们考虑了 2006 年 1 月至 12 月期间 86 例患者的 87 个连续病变,接受了 US 和/或 MMG 引导的 BCS 治疗。
86 例患者的平均年龄为 50.0 岁(范围 28-80 岁)。术前定位对于 49 个无微钙化的病变仅使用 US 进行,对于 38 个有微钙化的病变则使用 US 和 MMG 进行。87 个病变中 81 个(93.1%)被诊断为非粉刺型或混合性,6 个(6.9%)被诊断为粉刺型 DCIS。65 个病变(74.8%)被诊断为阴性边缘,15 个病变(17.2%)为接近边缘,7 个病变(8.0%)为阳性边缘。3 个(3.4%)无微钙化的病变仅使用 US 定位,在第二次手术中进行了额外切除。最大肿瘤大小与边缘状态相关(p=0.043)。
因此,US 和/或 MMG 引导的 BCS 是治疗 DCIS 患者的可靠方法,无论其组织病理学类型如何,并且具有对患者非侵入性和非应激性的优势。