当前乳腺交界性病变的管理实践——需要进一步的研究和指南。
Current management practice of breast borderline lesions--need for further research and guidelines.
机构信息
Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
出版信息
Am J Surg. 2012 Jun;203(6):721-5. doi: 10.1016/j.amjsurg.2011.06.052. Epub 2011 Dec 6.
BACKGROUND
Breast borderline lesions are usually diagnosed on needle biopsies of imaging abnormalities. The natural history of these lesions is unclear, and the literature is divided on appropriate management. It was hypothesized that management varies among surgeons and may be associated with surgeon and practice characteristics.
METHODS
A survey of 477 members of the American Society of Breast Surgeons was completed. Results were analyzed according to various surgeon and practice characteristics.
RESULTS
Most respondents recommended routine excision for atypical ductal and lobular hyperplasia. Excision of radial scars and papillomas was much more variable, with only 50% recommending routine excision. Results differed by surgical dedication to breast surgery and fellowship training. Management of atypical ductal or lobular hyperplasia found at the margin varied significantly. The lack of a routine tumor board, low breast case volume, and low percentage of breast cases were associated with routine excision in these cases.
CONCLUSIONS
Breast borderline lesions pose a clinical dilemma, with practice varying greatly among surgeons.
背景
乳腺边界性病变通常通过影像学异常的针吸活检进行诊断。这些病变的自然史尚不清楚，文献中对此存在分歧，因此适当的管理也存在差异。研究假设，不同外科医生的管理方式存在差异，可能与外科医生和手术特点有关。
方法
对美国乳腺外科学会的 477 名成员进行了一项调查。根据外科医生和手术特点的不同对结果进行了分析。
结果
大多数受访者建议对非典型导管和小叶增生进行常规切除。放射状瘢痕和乳头瘤的切除则更加多样化，只有 50%的受访者建议常规切除。手术对乳腺外科的专注程度和奖学金培训的不同，结果也有所不同。在切缘处发现的非典型导管或小叶增生的处理方式存在显著差异。缺乏常规肿瘤委员会、乳腺病例量低以及乳腺病例比例低与这些情况下的常规切除有关。
结论
乳腺边界性病变存在临床难题，不同外科医生的实践差异很大。
Zotero 插件