Vernet-Tomas María del Mar, Ortega Marisa, Vidal Sergi, Corominas José M, Carreras Ramon
Department of Obstetrics and Gynecology, Hospital Universitari del Mar, Autonomous University of Barcelona, Barcelona, Spain.
J Obstet Gynaecol Res. 2011 May;37(5):422-7. doi: 10.1111/j.1447-0756.2010.01374.x. Epub 2011 Jan 27.
Most breast surgeons generally assume that obtaining negative margins in nonpalpable tumors is a matter of concern. The aim of this study was to examine whether it is easier to obtain negative margins in palpable tumors than in nonpalpable tumors excised with the radioguided occult lesion localization (ROLL) technique.
A retrospective review was made of nonpalpable breast cancers excised with the ROLL technique (ROLL group, n = 83) and palpable breast cancers in which breast conservative therapy was performed (Palpable group, n = 77). The margin status and the size of the minimum margin obtained when it was negative were reviewed.
The percentage of resections with negative margins was similar in both groups: 51.9% in the Palpable group and 61.4% in the ROLL group. There was no difference between the two groups in the minimum margin obtained: mean ± SD, 5.53 ± 3.146 mm in the Palpable group and 5.96 ± 3.039 mm in the ROLL group. Risk factors for failing to obtain negative margins were analyzed in both groups and were similar. These risk factors included histological grade, extensive intraductal carcinoma and c-erbB2 status.
It is concluded that excision of nonpalpable breast tumors with the ROLL approach obtains similar results for margins as conservative surgery performed for palpable tumors.
大多数乳腺外科医生通常认为，在不可触及的肿瘤中实现切缘阴性是一个值得关注的问题。本研究的目的是检验在可触及肿瘤中获得阴性切缘是否比在采用放射性引导隐匿性病变定位（ROLL）技术切除的不可触及肿瘤中更容易。
对采用ROLL技术切除的不可触及乳腺癌（ROLL组，n = 83）和接受保乳治疗的可触及乳腺癌（可触及组，n = 77）进行回顾性分析。回顾切缘状态以及切缘阴性时获得的最小切缘大小。
两组切缘阴性的切除率相似：可触及组为51.9%，ROLL组为61.4%。两组获得的最小切缘无差异：可触及组平均±标准差为5.53±3.146 mm，ROLL组为5.96±3.039 mm。对两组中未获得阴性切缘的危险因素进行分析，结果相似。这些危险因素包括组织学分级、广泛导管内癌和c-erbB2状态。
得出结论，采用ROLL方法切除不可触及乳腺肿瘤在切缘方面取得的结果与对可触及肿瘤进行的保乳手术相似。
