Department of Radiation Oncology, Institut Oncològic del Vallés, Hospital Universitari General de Catalunya-Grupo Quirónsalud, Carrer Pedro i Pons 1, 08190 Sant Cugat del Vallés, Barcelona, Spain; Grup Oncològic Català-Occità, Catalunya, Spain.
Department of Radiation Oncology, Clínic Barcelona Hospital Universitari, Carrer Villarroel 170, 08036 Barcelona, Spain; Grup Oncològic Català-Occità, Catalunya, Spain.
Breast. 2017 Oct;35:196-202. doi: 10.1016/j.breast.2017.08.002. Epub 2017 Aug 11.
Reliable data on DCIS incidence and management are not available in many countries. The present study describes the management of DCIS in Catalonia, Spain in the year 2005 and compares these findings to data obtained in France. Local recurrence and late toxicity rates from 2005 through the end of 2014 are reported.
Observational survey of patients with pure DCIS (n = 270) diagnosed during 2005. A written questionnaire, the same as used in the French survey, was completed by 14 doctors at 12 cancer centres in Catalonia, Spain.
Median patient age was 55 years (range, 29-89). Diagnosis was mammographic in 225 cases (83.3%). Treatment approaches included: mastectomy (10.4% of cases), breast-conserving surgery (BCS) alone (3.7%), and BCS plus radiotherapy (RT) (85.5%). Sentinel node biopsy and axillary dissection were performed in 27.4% and 5.6% of patients, respectively. Hormonotherapy was prescribed in 45.2% of cases. Tumour nuclear grade was as follows: low (16.7% of cases), intermediate (23%), and high (55.6%). Excision was complete (margins ≥1 mm) in 75% of patients treated with BCS alone vs. 95.7% for BCS+RT. The treatment approach varied widely: mastectomy rates ranged from 7.1% to 26.7% of centres, BCS+RT from 55.5% to 87.8%, and hormonotherapy from 3.3% to 83.3%. At a median follow-up of 102.6 months, 14 patients (5.6%) presented ipsilateral breast tumour recurrence.
These findings on DCIS management in Catalonia are consistent with previous international reports. The inter-centre differences observed are similar to those reported in other international surveys during the same period.
在许多国家，有关 DCIS 发病率和治疗方法的可靠数据并不完备。本研究描述了 2005 年西班牙加泰罗尼亚地区 DCIS 的治疗方法，并将这些发现与同期法国获取的数据进行了比较。报告了 2005 年至 2014 年底的局部复发和晚期毒性发生率。
对 2005 年期间诊断为单纯 DCIS 的 270 例患者进行了观察性研究。西班牙 12 家癌症中心的 14 位医生填写了一份与法国研究相同的书面调查问卷。
中位患者年龄为 55 岁（范围，29-89 岁）。225 例（83.3%）诊断为乳腺 X 线摄影。治疗方法包括：乳房切除术（10.4%）、保乳手术（BCS）单独治疗（3.7%）和 BCS 加放疗（RT）（85.5%）。前哨淋巴结活检和腋窝清扫分别在 27.4%和 5.6%的患者中进行。45.2%的患者接受了激素治疗。肿瘤核分级为：低（16.7%）、中（23%）和高（55.6%）。单独接受 BCS 治疗的患者中，75%的患者切除完全（切缘≥1mm），而接受 BCS+RT 治疗的患者中，95.7%的患者切除完全。治疗方法差异很大：乳房切除术率从 7.1%到 26.7%不等，BCS+RT 率从 55.5%到 87.8%不等，激素治疗率从 3.3%到 83.3%不等。在中位随访 102.6 个月时，14 名患者（5.6%）出现同侧乳房肿瘤复发。
这些关于加泰罗尼亚 DCIS 治疗的发现与之前的国际报告一致。观察到的中心间差异与同期其他国际调查报道的差异相似。
