Eggemann Holm, Kalinski Thomas, Ruhland Anna K, Ignatov Tanja, Costa Serban Dan, Ignatov Atanas
Department of Obstetrics and Gynecology, University Clinic Magdeburg, Magdeburg, Germany.
Institute of Pathology, University Clinic Magdeburg, Magdeburg, Germany.
Clin Breast Cancer. 2015 Jun;15(3):227-33. doi: 10.1016/j.clbc.2014.11.008. Epub 2014 Dec 2.
Tumor specimens from 410 patients with primary invasive breast cancer were investigated to identify the clinically relevant features of tumor-associated intraductal component (IDC) surrounding invasive breast cancer. A tumor-associated IDC associated with invasive tumor was mostly localized between the tumor and nipple. Thus, segmental resection of breast tissue is suggested.
The goal of the present study was to identify the clinically relevant features of tumor-associated intraductal component (IDC) surrounding invasive breast cancer.
The tumor specimens from 410 patients with primary invasive breast cancer were investigated. The distance between the surgical margins and tumor edge (invasive and intraductal areas) was measured prospectively.
Of the 410 investigated patients, 395 were eligible for analysis. An IDC was observed in 241 specimens (61.0%) and was associated with a younger age at diagnosis, postmenopausal status, and positive estrogen receptor, progesterone receptor, and human epidermal growth factor 2 (HER2) expression status. Most cases with tumor-associated ductal carcinoma in situ (DCIS) were found in the upper-outer quadrants of the breasts. An extended intraductal component (EIC) tended to be present in the outer and lower quadrants of the breasts. In the study cohort of 187 patients with tumor-associated DCIS, 1496 surgical margins were investigated. IDC was associated with invasive tumor growth predominantly in the nipple direction. The nipple-associated growth of DCIS correlated with patient age > 40 years, tumor size ≤ 2 cm, poor histologic differentiation of the noninvasive and invasive components, and positive estrogen and progesterone receptor status and negative HER2 status.
Our data provide evidence that in patients with primary breast cancer, the EIC areas will be mostly segmentally localized between the invasive tumor and the nipple. Therefore, if EIC is present or assumed, surgery should consist of segmental resection of the breast tissue, at least in patients with breast cancer who are > 40 years old, with a tumor size of < 2 cm, and with hormone receptor-positive and HER2-negative, poorly differentiated tumors.
对410例原发性浸润性乳腺癌患者的肿瘤标本进行研究，以确定浸润性乳腺癌周围肿瘤相关导管内成分（IDC）的临床相关特征。与浸润性肿瘤相关的肿瘤相关IDC大多位于肿瘤与乳头之间。因此，建议进行乳腺组织的区段切除。
本研究的目的是确定浸润性乳腺癌周围肿瘤相关导管内成分（IDC）的临床相关特征。
对410例原发性浸润性乳腺癌患者的肿瘤标本进行研究。前瞻性测量手术切缘与肿瘤边缘（浸润和导管内区域）之间的距离。
在410例研究患者中，395例符合分析条件。在241份标本（61.0%）中观察到IDC，其与诊断时年龄较小、绝经后状态以及雌激素受体、孕激素受体和人表皮生长因子2（HER2）表达阳性有关。大多数伴有肿瘤相关导管原位癌（DCIS）的病例位于乳房的外上象限。扩展导管内成分（EIC）倾向于出现在乳房的外下象限。在187例伴有肿瘤相关DCIS的患者研究队列中，调查了1496个手术切缘。IDC与浸润性肿瘤主要向乳头方向生长相关。DCIS与乳头相关的生长与患者年龄>40岁、肿瘤大小≤2 cm、非浸润性和浸润性成分组织学分化差以及雌激素和孕激素受体阳性、HER2阴性状态相关。
我们的数据表明，在原发性乳腺癌患者中，EIC区域大多会区段性地位于浸润性肿瘤与乳头之间。因此，如果存在或怀疑有EIC，手术应包括乳腺组织的区段切除，至少对于年龄>40岁、肿瘤大小<2 cm、激素受体阳性且HER2阴性、分化差的乳腺癌患者。
