采用严格、统一的标准确定原位导管癌完全切除后，不进行全乳照射的手术切除。
Surgical excision without whole breast irradiation for complete resection of ductal carcinoma in situ identified using strict, unified criteria.
作者信息
Sakai Takehiko, Iwase Takuji, Teruya Natsuki, Kataoka Akemi, Kitagawa Dai, Nakashima Eri, Ogiya Akiko, Miyagi Yumi, Iijima Kotaro, Morizono Hidetomo, Makita Masujiro, Gomi Naoya, Oguchi Masahiko, Ito Yoshinori, Horii Rie, Akiyama Futoshi, Ohno Shinji
机构信息
Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
出版信息
Am J Surg. 2017 Jul;214(1):111-116. doi: 10.1016/j.amjsurg.2016.10.024. Epub 2016 Nov 30.
BACKGROUND
The definition of complete resection of ductal carcinoma in situ (DCIS) is difficult to standardize because of the high variety of surgical breast conserving procedures, specimen handling, and pathological examinations. Using strictly controlled criteria in a single institute, the present study aimed to determine the ipsilateral breast cancer rate when radiotherapy is omitted following complete resection of DCIS.
METHODS
We retrospectively examined 363 consecutive DCIS patients who underwent breast-conserving surgery, and of these, 125 (34.4%) had complete resection according to the criteria. We finally included 103 patients who omitted radiotherapy. Ipsilateral and contralateral breast cancer events were assessed.
RESULTS
The median follow-up period was 118 months. The incidences of ipsilateral and contralateral breast cancer and ipsilateral invasive breast cancer at 10 years were 10.8%, 9.1%, and 3.6%, respectively. No patient died of breast cancer.
CONCLUSION
If complete resection of DCIS can be ensured, the annual incidence of ipsilateral breast cancer, even without irradiation, can be limited to approximately 1%, which equals the incidence of contralateral breast cancer.
背景
由于保乳手术方式、标本处理及病理检查的多样性，导管原位癌（DCIS）完整切除的定义难以标准化。本研究在单一机构采用严格控制的标准，旨在确定DCIS完整切除后省略放疗时同侧乳腺癌的发生率。
方法
我们回顾性研究了363例接受保乳手术的DCIS连续患者，其中125例（34.4%）根据标准实现了完整切除。最终纳入103例省略放疗的患者。评估同侧和对侧乳腺癌事件。
结果
中位随访期为118个月。10年时同侧和对侧乳腺癌及同侧浸润性乳腺癌的发生率分别为10.8%、9.1%和3.6%。无患者死于乳腺癌。
结论
如果能够确保DCIS完整切除，即使不进行放疗，同侧乳腺癌的年发生率也可限制在约1%，这与对侧乳腺癌的发生率相当。
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