Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, USA.
Breast. 2011 Feb;20(1):71-7. doi: 10.1016/j.breast.2010.07.005. Epub 2010 Aug 23.
The effect of increasing age on outcomes and type of treatment given to older women with ductal carcinoma in situ (DCIS) was assessed. 646 women ≥60 years old (654 cases) receiving surgery for DCIS at Memorial Sloan-Kettering Cancer Center between 2000 and 2007 (8 bilateral) had wide local excision (WLE; 37%), WLE plus radiotherapy (WLE+RT; 41%), or mastectomy (22%). 45%, 38%, and 16% of patients 60-69 years, 70-79 years, and ≥80 years, respectively, received WLE+RT (P<0.001) and 25%, 20%, and 13%, received mastectomy, respectively (P<0.001). Age (P<0.001), grade (P<0.001), and necrosis (P<0.01) were highly associated with treatment. Four-year local recurrence was 3.6%. Overall local recurrence differed by treatment (mastectomy, 0%; WLE, 5%; WLE+RT, 4%; P<0.00001) but not age. It is possible to identify older women with DCIS in whom the risk of recurrence is acceptably low after WLE alone. WLE alone may be a viable treatment option for select older women with DCIS.
评估了年龄增长对老年女性导管原位癌（DCIS）患者的结局和治疗类型的影响。2000 年至 2007 年间，纪念斯隆-凯特琳癌症中心（Memorial Sloan-Kettering Cancer Center）有 646 名年龄≥60 岁（654 例）的女性因 DCIS 接受手术治疗（8 例为双侧），包括广泛局部切除术（WLE；37%）、WLE 加放疗（WLE+RT；41%）或乳房切除术（22%）。分别有 45%、38%和 16%的 60-69 岁、70-79 岁和≥80 岁患者接受了 WLE+RT（P<0.001），分别有 25%、20%和 13%的患者接受了乳房切除术（P<0.001）。年龄（P<0.001）、分级（P<0.001）和坏死（P<0.01）与治疗高度相关。4 年局部复发率为 3.6%。总体局部复发与治疗相关（乳房切除术，0%；WLE，5%；WLE+RT，4%；P<0.00001），但与年龄无关。对于仅接受 WLE 治疗后复发风险可接受较低的老年 DCIS 患者，有可能确定。单独的 WLE 可能是老年 DCIS 患者的一种可行治疗选择。
