手术、放疗及全身治疗对导管原位癌患者预后的影响。
The impact of surgery, radiation, and systemic treatment on outcomes in patients with ductal carcinoma in situ.
作者信息
Kane Robert L, Virnig Beth A, Shamliyan Tatyana, Wang Shi-Yi, Tuttle Todd M, Wilt Timothy J
机构信息
Division of Health Policy and Management, University of Minnesota School of Public Health, D351 Mayo (MMC 729), 420 Delaware St SE, Minneapolis, MN 55455, USA.
出版信息
J Natl Cancer Inst Monogr. 2010;2010(41):130-3. doi: 10.1093/jncimonographs/lgq022.
Abstract
BACKGROUND
Ductal carcinoma in situ (DCIS) is associated with low rates of mortality. Outcomes are generally assessed in terms of recurrence.
METHODS
Published studies were abstracted from MEDLINE and other sources. We include articles published through January 31, 2009; 10 publications of five randomized controlled trials and 133 publications of 64 observational studies were reviewed.
RESULTS
Whole-breast radiation therapy following breast-conserving surgery (BCS) was consistently associated with a reduced incidence of local DCIS recurrence and local invasive carcinoma. Women undergoing mastectomy were less likely than women undergoing lumpectomy with or without radiation to experience local DCIS or invasive recurrence. Tamoxifen use reduced risk of recurrent DCIS or invasive carcinoma.
CONCLUSIONS
BCS plus radiation and mastectomy appear to yield equivalent outcomes, whereas BCS alone tends to be inferior to mastectomy. Tamoxifen seems helpful in treating DCIS.
摘要
背景
导管原位癌（DCIS）的死亡率较低。通常根据复发情况评估其预后。
方法
从MEDLINE及其他来源提取已发表的研究。纳入截至2009年1月31日发表的文章；对5项随机对照试验的10篇出版物和64项观察性研究的133篇出版物进行了综述。
结果
保乳手术（BCS）后进行全乳放疗与局部DCIS复发和局部浸润性癌的发生率降低始终相关。接受乳房切除术的女性比接受保乳手术（无论是否放疗）的女性发生局部DCIS或浸润性复发的可能性更小。使用他莫昔芬可降低复发性DCIS或浸润性癌的风险。
结论
BCS加放疗和乳房切除术似乎能产生等效的结果，而单纯BCS往往不如乳房切除术。他莫昔芬似乎有助于治疗DCIS。
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