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预测早期乳腺癌保乳治疗后的局部复发:手术切缘狭窄(≤2mm)的意义。

Predicting local recurrence following breast-conserving therapy for early stage breast cancer: the significance of a narrow (≤ 2 mm) surgical resection margin.

机构信息

Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

出版信息

J Surg Oncol. 2011 Mar 1;103(3):212-6. doi: 10.1002/jso.21826. Epub 2011 Jan 15.

Abstract

BACKGROUND AND OBJECTIVES

Controversy continues over the extent of surgical resection margin required to minimize the risk of local recurrence (LR) in breast-conserving therapy (BCT) for early stage breast cancer. This study explores whether or not a narrow (≤ 2 mm) but negative resection margin affects LR.

METHODS

All patients registered at the Saskatoon Cancer Center between January 1, 1991 and December 31, 2000 with a diagnosis of early stage invasive duct carcinoma treated with BCT were examined. All charts and pathology reports were reviewed with a review of the pathology for all cases where the resection margin was unclear in the original report. Other factors known or thought to effect LR (age, radiation boost, grade, extensive DCIS, ER/PR receptor status) were considered in the statistical analysis.

RESULTS

Amongst the 200 narrow margin cases 19 LR were detected (19/201 = 9.5%) while 52 LR were detected in the 491 wide margin cases (52/491 =10.6%). This difference was not statistically significant.

CONCLUSIONS

A narrow (≤ 2 mm) surgical resection margin does not result in an increase in LR compared to a surgical resection margin 2 mm in BCT for early stage duct carcinoma and does not warrant re-excision.

摘要

背景与目的

在早期乳腺癌保乳治疗(BCT)中,为了最大限度地降低局部复发(LR)的风险,需要多大范围的手术切缘仍存在争议。本研究旨在探讨切缘狭窄(≤2mm)但为阴性是否会影响 LR。

方法

对 1991 年 1 月 1 日至 2000 年 12 月 31 日期间在萨斯卡通癌症中心登记的所有接受 BCT 治疗的早期浸润性导管癌患者进行了研究。对所有原始报告中切缘不明确的病例进行了图表和病理报告审查,并对所有病例的病理进行了复查。对其他已知或认为会影响 LR 的因素(年龄、放疗增量、分级、广泛的 DCIS、ER/PR 受体状态)进行了统计学分析。

结果

在 200 例狭窄切缘病例中,19 例(19/201=9.5%)检测到 LR,而在 491 例宽切缘病例中,52 例(52/491=10.6%)检测到 LR。这种差异无统计学意义。

结论

与 BCT 治疗早期导管癌时 2mm 的手术切缘相比,狭窄(≤2mm)的手术切缘并不会增加 LR,也不需要再次切除。

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