Baker R R, Kuhajda F P
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
Ann Surg. 1989 Oct;210(4):444-7; discussion 447-8. doi: 10.1097/00000658-198910000-00004.
Ninety-nine patients with the diagnosis of lobular carcinoma (LC) treated between 1970 and 1981 were reviewed. Thirteen patients had a contralateral mastectomy for duct cancer (DC) before the diagnosis of LC. Ten of the remaining 86 patients (11%) had simultaneous bilateral cancers detected by either physical examination or mammography, none by blind biopsy. Three of the surviving 38 patients (7.8%) developed a contralateral cancer an average of 143 months after operation. In comparison 167 patients with DC treated during the same period of time had a 1.8% incidence of synchronous cancer but the same incidence of subsequent cancer (7%). Lobular carcinoma in situ was not a reliable marker for predicting the presence of cancers in the contralateral breast. The diagnosis of LC is not an indication for either biopsy or removal of a normal contralateral breast.
回顾了1970年至1981年间确诊为小叶癌（LC）的99例患者。13例患者在LC诊断前因导管癌（DC）接受了对侧乳房切除术。其余86例患者中有10例（11%）通过体格检查或乳房X线摄影发现同时患有双侧癌症，通过盲目活检均未发现。38例存活患者中有3例（7.8%）在术后平均143个月发生了对侧癌症。相比之下，同期接受治疗的167例DC患者同步癌症的发生率为1.8%，但后续癌症的发生率相同（7%）。小叶原位癌不是预测对侧乳房癌症存在的可靠标志物。LC的诊断并非对正常对侧乳房进行活检或切除的指征。
