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乳腺非浸润性导管癌(作者译)

[Non-infiltrating intraductal carcinoma of the breast (author's transl)].

作者信息

Contesso G, Petit J Y

出版信息

Bull Cancer. 1979;66(1):1-8.

PMID:217470
Abstract

Non-infiltrating intraductal carcinoma may be considered a type of "carcinoma in situ" of the breast. In a review of 47 cases diagnosed and treated at Gustave-Roussy Institute between 1956--1972, it appears that the early symptoms of this rare type of breast carcinoma (it occurs only in 2.4% of all breast cancers) were a bloody discharge (38%) or Paget's disease of the nipple (11%). The histological examination was of the utmost importance in these cases due to the diagnostic uncertainties between benign hyperplastic lesions and authentic carcinomas as well as between infiltrating carcinomas and strictly intraductal carcinomas. Frozen section was only accurate in 30% of cases. The high frequency of multicentric foci (76%) contrasted with the absence of lymph node involvment (none of the 23 cases in which at least one node was excised, showed lymph node metastases). Treatment was only of ablation of the whole mammary gland, except in 6 patients who had a tumorectomy, two of whom also received radiotherapy. Local recurrence occurred in 4 patients, 3 of whom had only tumorectomy. The contralateral breast was affected in 2 cases. No patient under follow-up died of cancer within 5 years. The peculiar and highly favorable course of non-infiltrating intraductal carcinoma calls for an adequate therapy which could later be followed by a plastic reconstructive surgery should the patient wish to have this procedure.

摘要

非浸润性导管癌可被视为一种乳腺“原位癌”。在对1956年至1972年期间在古斯塔夫 - 鲁西研究所诊断和治疗的47例病例进行回顾时发现,这种罕见类型的乳腺癌(仅占所有乳腺癌的2.4%)的早期症状为血性溢液(38%)或乳头派杰氏病(11%)。由于良性增生性病变与真正的癌之间以及浸润性癌与严格的导管内癌之间存在诊断不确定性,组织学检查在这些病例中至关重要。冰冻切片仅在30%的病例中准确。多中心病灶的高频率(76%)与无淋巴结受累形成对比(在至少切除一个淋巴结的23例病例中,无一例显示有淋巴结转移)。治疗仅为全乳腺切除,除了6例行肿瘤切除术的患者,其中2例还接受了放疗。4例患者出现局部复发,其中3例仅行了肿瘤切除术。2例对侧乳腺受累。随访期间无患者在5年内死于癌症。非浸润性导管癌独特且预后极佳的病程需要采取适当的治疗方法,如果患者希望进行该手术,随后可进行整形重建手术。

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