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从国家筛查计划看小叶性乳腺癌的外科治疗:回顾性分析。

Surgical management of lobular carcinoma from a national screening program: a retrospective analysis.

机构信息

University College Dublin, Ireland.

Breastcheck, National Cancer Control Program, Ireland; Mater Misericordiae University Hospital, Ireland.

出版信息

Eur J Surg Oncol. 2015 Jan;41(1):79-85. doi: 10.1016/j.ejso.2014.09.004. Epub 2014 Oct 2.

Abstract

OBJECTIVE

To compare the surgical outcomes of women diagnosed with invasive ductal and lobular carcinoma of the breast.

BACKGROUND

The role of Breast Conserving Surgery (BCS) for invasive cancers of the breast is well established; however its role for invasive lobular carcinoma is less well defined. Concerns exist regarding the need for re-excision of margins and the eventual need for mastectomy in women with Invasive Lobular Carcinoma (ILC) compared with Ductal Carcinoma (IDC). In this study we compare the surgical results of these two groups examining BCS from a national breast cancer screening program.

METHODS

Analysis of mammographically detected ILC and IDC tumours obtained from the national breast cancer screening program of the Republic of Ireland (BreastCheck) was performed. BreastCheck offers biannual screening mammograms to women throughout the Republic of Ireland between 50 and 65 years of age. We examined and pooled the data across 4 screening zones from 2005 to 2010.

CONCLUSIONS

We observed similar success rates and trends in both the ILC and IDC groups where BCS was attempted. Patients selected for BCS with ILC were statistically more likely to have successful surgery compared with IDC as tumour size increased. There however was no statistical difference in a pooled analysis of successful treatment across all tumour sizes in comparing the two groups. We conclude that BCS is an appropriate and acceptable treatment option for women diagnosed with ILC.

摘要

目的

比较诊断为乳腺浸润性导管癌和浸润性小叶癌女性的手术结果。

背景

保乳手术(BCS)在乳腺浸润性癌中的作用已得到充分证实;然而,其在浸润性小叶癌中的作用尚未得到充分明确。与导管癌(IDC)相比,浸润性小叶癌(ILC)患者在切缘需要再次切除以及最终需要乳房切除术方面存在担忧。在这项研究中,我们从全国乳腺癌筛查计划中比较了这两组患者的手术结果,研究了保乳手术。

方法

对爱尔兰共和国(BreastCheck)全国乳腺癌筛查计划中获得的乳腺 X 线筛查检测到的 ILC 和 IDC 肿瘤进行了分析。BreastCheck 为年龄在 50 至 65 岁之间的爱尔兰共和国的女性提供每两年一次的筛查性乳房 X 光检查。我们对 2005 年至 2010 年的 4 个筛查区的数据进行了检查和汇总。

结论

我们观察到在尝试 BCS 的 ILC 和 IDC 两组中,成功率和趋势相似。与 IDC 相比,随着肿瘤大小的增加,选择接受 BCS 的 ILC 患者的手术成功的可能性具有统计学意义。然而,在比较两组患者时,对所有肿瘤大小的成功治疗进行汇总分析,并没有发现统计学差异。我们的结论是,BCS 是诊断为 ILC 的女性的一种合适且可接受的治疗选择。

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