Kim Haeyoung, Noh Jae Myoung, Choi Doo Ho, Lee Jihye, Nam Seok Jin, Lee Jeong Eon, Park Won, Huh Seung Jae
Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, South Korea.
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea.
Breast. 2014 Oct;23(5):586-90. doi: 10.1016/j.breast.2014.05.025. Epub 2014 Jun 23.
This study was performed to determine the risk of tumor recurrence after local excision alone in patients with small size (≤1 cm) ductal carcinoma in situ (DCIS) of the breast. We have treated 107 patients who had DCIS measuring ≤1 cm with margin widths of ≥0.3 cm with excision alone per institutional protocol. With a median follow-up time of 58 months, 4 patients developed ipsilateral breast tumor recurrence (IBTR). Two of the 4 recurrences were invasive, whereas 2 were DCIS. The 5-year rate of IBTR was 6.1%. The patients with resection margin of <1.0 cm had significantly higher rate of IBTR than the patients with resection margin of ≥1.0 cm (23.1% vs. 1.5% at 5-year, p < 0.01). In conclusion, radiotherapy is necessary in the patients with resection margin of <1.0 cm after excision alone because of the substantial risk of IBTR.
本研究旨在确定乳腺小尺寸（≤1 cm）导管原位癌（DCIS）患者单纯局部切除术后肿瘤复发的风险。我们按照机构方案，对107例DCIS大小≤1 cm且切缘宽度≥0.3 cm的患者进行了单纯切除治疗。中位随访时间为58个月，4例患者出现同侧乳腺肿瘤复发（IBTR）。4例复发中有2例为浸润性，2例为DCIS。IBTR的5年发生率为6.1%。切缘<1.0 cm的患者IBTR发生率显著高于切缘≥1.0 cm的患者（5年时分别为23.1%和1.5%，p<0.01）。总之，对于单纯切除术后切缘<1.0 cm的患者，由于IBTR风险较高，放疗是必要的。
