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超声引导和/或乳腺 X 线摄影引导下的乳腺导管原位癌保乳手术:87 例病变的经验。

Ultrasonography- and/or mammography-guided breast conserving surgery for ductal carcinoma in situ of the breast: experience with 87 lesions.

机构信息

Department of Breast Surgical Oncology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan.

出版信息

Breast Cancer. 2012 Apr;19(2):131-7. doi: 10.1007/s12282-010-0218-5. Epub 2010 Aug 21.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

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