Academic Division of Gynaecology and Obstetrics, Mauriziano Hospital "Umberto I", University of Turin, Largo Turati 62, Turin, Italy.
Eur J Surg Oncol. 2013 May;39(5):455-60. doi: 10.1016/j.ejso.2013.02.007. Epub 2013 Mar 13.
A retrospective analysis on 1407 patients with invasive ductal carcinoma (IDC) and 243 invasive lobular carcinoma (ILC) was performed in order to compare the histological features, the immunohistochemical characteristics, the surgical treatment and the clinical outcome in the two groups.
ILC seems to be more likely multifocal, estrogen receptor positive, HER-2 negative and to have a lower proliferative index compared to IDC. ILC, when treated with conservative surgery, required more frequently re-excision and/or mastectomy because of positive resection margins. No difference was observed in terms of 5-year disease free survival and local relapse free survival between the two groups, in the whole series and in the subgroup of patients treated with breast-conserving treatment.
ILC can be safely treated with conservative surgery but a more accurate preoperative evaluation of tumor size and multifocality could be advocated, in order to reduce the re-excision rate.
对 1407 例浸润性导管癌(IDC)和 243 例浸润性小叶癌(ILC)患者进行回顾性分析,比较两组患者的组织学特征、免疫组织化学特征、手术治疗和临床结果。
与 IDC 相比,ILC 似乎更有可能呈多灶性,雌激素受体阳性,HER-2 阴性,增殖指数较低。行保乳手术的 ILC 由于切缘阳性,更常需要再次切除和/或乳房切除术。在全系列和接受保乳治疗的患者亚组中,两组患者的 5 年无病生存率和局部无复发生存率无差异。
ILC 可以安全地行保乳手术治疗,但为了降低再次切除率,可提倡更准确地术前评估肿瘤大小和多灶性。