Hardman P D, Worth A, Lee U, Baird R M
Division of Radiation Oncology, Cancer Control Agency of British Columbia, Vancouver.
Can J Surg. 1989 Jan;32(1):56-60.
Between Jan. 1, 1985 and Aug. 31, 1987, 62 in-situ ductal carcinomas with a predominantly comedo pattern were identified in 61 patients in British Columbia from excisional biopsy of a palpable or mammographically demonstrable lesion of a breast. The biopsies were intended to remove the lesion completely. Fifty-seven (92%) of the 61 patients required wide re-excision or total mastectomy, usually within a month of the initial biopsy. Occult invasive disease was demonstrated in 14 of the re-excision specimens (24.5%) and residual in-situ carcinoma was present in a further 24 (42.1%), giving an overall rate of residual disease of 66.6%. Axillary lymph nodes were sampled in 54 cases. Metastases were found in two cases (3.7%) and each was associated with occult infiltrating ductal carcinoma in the breast. This suggests that in-situ ductal carcinoma having a predominant comedo pattern may be more widespread and associated with a higher incidence of invasive ductal carcinoma than is generally believed.
1985年1月1日至1987年8月31日期间，在不列颠哥伦比亚省，通过对乳房可触及或乳腺X线检查可显示的病变进行切除活检，在61名患者中发现了62例主要为粉刺型的原位导管癌。活检旨在完全切除病变。61名患者中有57名（92%）需要进行广泛再次切除或全乳切除术，通常在初次活检后的一个月内进行。在14例再次切除标本中发现隐匿性浸润性疾病（24.5%），另有24例（42.1%）存在残留原位癌，残留疾病的总体发生率为66.6%。对54例患者进行了腋窝淋巴结取样。发现2例转移（3.7%），且每例均与乳腺隐匿性浸润性导管癌相关。这表明，主要为粉刺型的原位导管癌可能比一般认为的更为广泛，且与浸润性导管癌的更高发生率相关。
