多灶性乳腺癌保乳手术的可行性

Feasibility of breast conserving surgery in multifocal breast cancers.

作者信息

Kadioğlu Hüseyin, Yücel Serap, Yildiz Seyma, Bozkurt Süleyman, Ersoy Yeliz Emine, Sağlam Esra, Müslümanoğlu Mahmut

机构信息

Department of General Surgery, Bezmialem Vakıf Üniversitesi, Tıp Fakültesi Hastanesi, Fatih/Istanbul 34083, Turkey.

Department of Radiation Oncology, Bezmialem Vakıf Üniversitesi, Fatih/Istanbul, Turkey.

出版信息

Am J Surg. 2014 Sep;208(3):457-64. doi: 10.1016/j.amjsurg.2013.08.008. Epub 2013 Oct 7.

DOI:10.1016/j.amjsurg.2013.08.008

PMID:24112680

Abstract

BACKGROUND

Multifocal breast cancers (MFBCs) present a challenge to surgeons. Although its feasibility is still controversial, breast-conserving surgery (BCS) is not contraindicated for MFBCs. The investigators retrospectively evaluated the feasibility of BCS and reviewed histopathologic findings in patients with MFBC.

METHODS

A total of 222 patients with MFBC who were treated with either BCS (119 patients) or mastectomy (103 patients) at a single institution between January 2002 and December 2011 were retrospectively evaluated.

RESULTS

The median follow-up time was 55 months (range, 10 to 102 months). Lymphovascular invasion and lymph node involvement were significantly less frequent in the BCS group (48.8% vs 62.2% for lymphovascular invasion, P = .04; 52.1% vs 71.8% for lymph node involvement, P = .002). There were no differences in local recurrence rates between the 2 groups. The overall survival rates were 92% in the BCS group and 72% in the mastectomy group (P = .000).

CONCLUSIONS

BCS is a feasible and safe procedure for the removal of multifocal tumors. Extended lymphovascular invasion is associated with mortality in patients who undergo mastectomy.

摘要

背景

多灶性乳腺癌（MFBC）给外科医生带来了挑战。尽管其可行性仍存在争议，但保乳手术（BCS）并非MFBC的禁忌证。研究人员回顾性评估了BCS的可行性，并复查了MFBC患者的组织病理学结果。

方法

回顾性评估了2002年1月至2011年12月期间在单一机构接受BCS治疗（119例患者）或乳房切除术（103例患者）的222例MFBC患者。

结果

中位随访时间为55个月（范围10至102个月）。BCS组的淋巴管侵犯和淋巴结受累明显较少（淋巴管侵犯：48.8%对62.2%，P = 0.04；淋巴结受累：52.1%对71.8%，P = 0.002）。两组之间的局部复发率无差异。BCS组的总生存率为92%，乳房切除组为72%（P = 0.000）。