Schwartz G F, Patchefsky A S, Finklestein S D, Sohn S H, Prestipino A, Feig S A, Singer J S
Department of Surgery, Jefferson Medical College, Philadelphia, PA.
Arch Surg. 1989 Jan;124(1):29-32. doi: 10.1001/archsurg.1989.01410010035007.
Fifty breasts with nonpalpable ductal carcinoma in situ (DCIS) were examined for the presence of microinvasion, multicentricity, and number of involved ducts to see if the biopsy specimen could have predicted the findings in the remainder of the breast. When DCIS was an incidental finding, fewer ducts were involved and no evidence of either microinvasion or multicentricity was found. Solid and cribriform DCIS were rarely multicentric or microinvasive; micropapillary DCIS was often multicentric, rarely microinvasive; comedocarcinoma was more likely to be both microinvasive and multicentric. Ductal carcinoma in situ as an incidental finding may be treated by excision alone; papillary and micropapillary DCIS are best treated by therapy aimed at the entire breast, although axillary dissection may not be required. Therapy for comedocarcinomas should include the entire breast and the axillary nodes.
对50例不可触及的导管原位癌（DCIS）乳房进行检查，以确定是否存在微浸润、多中心性以及受累导管数量，从而判断活检标本能否预测乳房其余部分的情况。当DCIS为偶然发现时，受累导管较少，且未发现微浸润或多中心性的证据。实性和筛状DCIS很少为多中心或微浸润性；微乳头型DCIS常为多中心性，很少有微浸润；粉刺癌更可能同时具有微浸润性和多中心性。偶然发现的导管原位癌可仅通过切除治疗；乳头型和微乳头型DCIS最好采用针对整个乳房的治疗方法，尽管可能不需要腋窝清扫。粉刺癌的治疗应包括整个乳房和腋窝淋巴结。
