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保乳治疗可切除性的预测因素。

Predictors of resectability in breast-conserving therapy.

机构信息

Department of Gynecology and Obstetrics, University of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany.

出版信息

Arch Gynecol Obstet. 2012 Oct;286(4):1023-31. doi: 10.1007/s00404-012-2401-8. Epub 2012 Jun 17.

Abstract

BACKGROUND

Our goal is to identify subgroups of women undergoing breast-conserving therapy (BCT) who are at increased risk for requiring a secondary surgical procedure, and to identify tumor and patient profiles that will allow surgeons to anticipate the need for taking larger margins when removing the tumor.

METHODS

One hundred female patients who had palpable, invasive carcinomas of the breast, and had undergone a primary BCT, were included in the study. Of these, all women (n = 25) who had incomplete resections, or questionable margins of resection, had to undergo re-excisions.

RESULTS

Patients who had multifocal disease, accompanying ductal carcinoma in situ, involvement of regional lymph nodes, high-grade breast cancer (Grade 3 vs. 1/2), lympho-vascular invasion or negative hormone-receptor-status, were significantly more likely to have undergone incomplete removal of tumor tissue-these patients thus required a secondary surgery.

CONCLUSION

The clinical and pathological predictors described above indicate that surgery in breast cancer patients meeting these criteria require larger safety margins to minimize the incidence rate of re-excision at a later date.

摘要

背景

我们的目标是确定接受保乳治疗(BCT)的女性中需要进行二次手术的风险增加的亚组,并确定肿瘤和患者特征,以便外科医生能够预测在切除肿瘤时需要切除更大的边缘。

方法

本研究纳入了 100 名接受过乳房可触及浸润性癌且已接受过原发性 BCT 的女性。其中,所有(n=25)不完全切除或切除边缘可疑的女性均需进行再次切除。

结果

患有多灶性疾病、伴有导管原位癌、区域淋巴结受累、高级别乳腺癌(3 级比 1/2 级)、淋巴管血管侵犯或激素受体阴性的患者,更有可能未能完全切除肿瘤组织——这些患者因此需要进行二次手术。

结论

上述临床和病理预测因素表明,符合这些标准的乳腺癌患者的手术需要更大的安全边缘,以最大限度地降低日后再次切除的发生率。

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