Omranipour Ramesh, Alipour Sadaf, Hadji Maryam, Bagheri Khojasteh
Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran E-mail :
Asian Pac J Cancer Prev. 2014;15(6):2771-6. doi: 10.7314/apjcp.2014.15.6.2771.
Breast cancer screening and higher quality mammography have resulted in an increase in the diagnosis of ductal carcinoma in situ worldwide. We compared the incidence and other factors in our cases of ductal carcinoma in situ between two recent decades.
Medical records of cases of ductal carcinoma in situ who had been admitted to the surgery wards of the Cancer Institute of Tehran, Iran were evaluated from March 1993 to March 2003 as phase 1, and from April 2003 to April 2013 as phase 2.
Ratio of ductal carcinoma in situ to overall breast cancer was 1.27 and 3.93 in phases 1 and 2, respectively. Rates of excisional or incisional biopsies versus core needle biopsies and clinically versus mammographically detected cases as well as median size of tumors dropped between the 2 phases while a substantial rise in the number of patients attending for screening was seen in this time period. Surgical treatments followed a trend from modified radical mastectomy and axillary lymphatic dissection toward breast conserving surgery and sentinel node dissection or no axillary intervention.
Our study shows a considerable trend toward earlier detection of breast cancer and evolution of treatment strategies toward standard less invasive surgery of DCIS in Iran.
乳腺癌筛查及更高质量的乳腺钼靶检查已使全球导管原位癌的诊断率有所上升。我们比较了近二十年间我院导管原位癌病例的发病率及其他因素。
对1993年3月至2003年3月期间收治于伊朗德黑兰癌症研究所外科病房的导管原位癌病例的病历资料进行评估作为第1阶段，2003年4月至2013年4月期间的病例作为第2阶段。
第1阶段和第2阶段导管原位癌与总体乳腺癌的比例分别为1.27和3.93。两个阶段之间，切除活检或切开活检与粗针活检的比例、临床发现与钼靶检查发现病例的比例以及肿瘤的中位大小均有所下降，而在此期间进行筛查的患者数量大幅增加。手术治疗方式从改良根治性乳房切除术和腋窝淋巴结清扫术逐渐转向保乳手术和前哨淋巴结清扫术或不进行腋窝干预。
我们的研究表明，在伊朗，乳腺癌早期检测呈现出显著趋势，且治疗策略正朝着导管原位癌标准的微创外科手术发展。
