Fodor János, Major Tibor, Tóth József, Sulyok Zoltán, Polgár Csaba
Department of Radiotherapy, National Institute of Oncology, Ráth Gy. u. 7-9, Budapest H-1122, Hungary.
Department of Pathology, National Institute of Oncology, Budapest, Hungary.
Rep Pract Oncol Radiother. 2011 Jul 27;16(6):227-31. doi: 10.1016/j.rpor.2011.06.005. eCollection 2011.
Invasive lobular cancer (ILC) is biologically distinct from invasive ductal cancer and there is disagreement regarding appropriate local management of this disease.
The current study reports long term results comparing mastectomy with breast-conserving surgery (BCS) in the treatment of ILC.
Study includes 235 women with ILC treated between 1983 and 1987. All of them underwent axillary dissection and either mastectomy (n = 163) or BCS (n = 72). 50 Gy adjuvant radiotherapy (RT) was given for 53 BCS and 81 mastectomy patients. The BCS group was compared with the mastectomy group.
Patients treated with mastectomy or BCS had a similar outcome at 15 years with regard to distant metastasis-free (62% vs. 70%; p, 0.2017) and breast cancer-specific (62% vs. 70%; p, 0.1728) survival. In the BCS group the actuarial rate of ipsilateral in breast recurrences was 10% with and 53% without RT at 15 years (relative risk [RR], 0.10; p < 0.0001). In the mastectomy group the actuarial rate of chest wall recurrences was 16% with and 13% without RT at 15 years (RR, 1.45; p, 0.3965). Isolated ipsilateral in breast recurrence did not (RR, 1.73; p, 0.2767) but isolated chest-wall recurrence did (RR, 2.65; p, 0.0089) adversely affect cause-specific survival.
Breast cancer specific survival is not affected by the type of surgical treatment. BCS and RT is a safe option to control local disease in patients with ILC.
浸润性小叶癌（ILC）在生物学上与浸润性导管癌不同，对于该疾病的适当局部治疗存在分歧。
本研究报告了在ILC治疗中，比较乳房切除术与保乳手术（BCS）的长期结果。
研究纳入了1983年至1987年间接受治疗的235例ILC女性患者。她们均接受了腋窝清扫术，其中163例行乳房切除术，72例行BCS。53例BCS患者和81例乳房切除术患者接受了50 Gy的辅助放疗（RT）。将BCS组与乳房切除术组进行比较。
接受乳房切除术或BCS治疗的患者在15年时，无远处转移生存率（62%对70%；p，0.2017）和乳腺癌特异性生存率（62%对70%；p，0.1728）相似。在BCS组中，15年时接受RT和未接受RT的同侧乳房复发精算率分别为10%和53%（相对风险[RR]，0.10；p<0.0001）。在乳房切除术组中，15年时接受RT和未接受RT的胸壁复发精算率分别为16%和13%（RR，1.45；p，0.3965）。孤立的同侧乳房复发未（RR，1.73；p，0.2767）但孤立的胸壁复发（RR，2.65；p，0.0089）对病因特异性生存率有不利影响。
乳腺癌特异性生存率不受手术治疗类型的影响。BCS联合RT是控制ILC患者局部疾病的安全选择。
