Ketcham A S, Moffat F L
Department of Surgery, University of Miami School of Medicine, FL 33101.
Cancer. 1990 Feb 1;65(3):387-93. doi: 10.1002/1097-0142(19900201)65:3<387::aid-cncr2820650302>3.0.co;2-y.
In situ cancer of the breast is being diagnosed with increasing frequency due to the widespread use of mammography and heightened awareness of these lesions among pathologists. Treatment of these preinvasive cancers is controversial in light of recent data supporting breast-conserving therapy for small invasive cancers. Therapy for in situ breast cancer is discussed with attention to known risk factors for recurrence and breast cancer-related mortality. The controversies surrounding treatment of ductal and lobular carcinoma in situ compel the conscientious oncologist to seek fully informed consent and to respect the individual patient's feelings about cosmesis and breast cancer risk. Hopefully, prospective randomized studies such as the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-17 trial will relieve the oncology community of much of its confusion about the natural history and optimal therapy for these diseases.
由于乳房X线摄影的广泛应用以及病理学家对这些病变的认识提高，乳腺原位癌的诊断频率日益增加。鉴于最近支持对小浸润性癌进行保乳治疗的数据，这些癌前病变的治疗存在争议。本文讨论了乳腺原位癌的治疗，并关注已知的复发风险因素及与乳腺癌相关的死亡率。围绕导管原位癌和小叶原位癌治疗的争议，促使尽责的肿瘤学家寻求充分知情同意，并尊重个体患者对美观及乳腺癌风险的感受。希望诸如国家外科辅助乳腺和肠道项目（NSABP）B - 17试验等前瞻性随机研究，能消除肿瘤学界对这些疾病自然史和最佳治疗方法的许多困惑。
