Kadioğlu Hüseyin, Yücel Serap, Yildiz Seyma, Bozkurt Süleyman, Ersoy Yeliz Emine, Sağlam Esra, Müslümanoğlu Mahmut
Department of General Surgery, Bezmialem Vakıf Üniversitesi, Tıp Fakültesi Hastanesi, Fatih/Istanbul 34083, Turkey.
Department of Radiation Oncology, Bezmialem Vakıf Üniversitesi, Fatih/Istanbul, Turkey.
Am J Surg. 2014 Sep;208(3):457-64. doi: 10.1016/j.amjsurg.2013.08.008. Epub 2013 Oct 7.
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.
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.
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).
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.
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。
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。
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）。
BCS是切除多灶性肿瘤的一种可行且安全的手术。广泛的淋巴管侵犯与接受乳房切除术患者的死亡率相关。
