Sunshine J A, Moseley H S, Fletcher W S, Krippaehne W W
Am J Surg. 1985 Jul;150(1):44-51. doi: 10.1016/0002-9610(85)90008-x.
We have retrospectively reviewed 112 cases of in situ carcinoma of the breast treated between 1960 to 1972, with a minimum 10 year follow-up to correlate treatment with outcome. We concluded that bilateral simple mastectomy with low axillary dissection is the treatment of choice for intraductal or lobular carcinoma in situ. This conclusion was based on the early age at diagnosis, the high incidence of bilaterality, and the long latency and probable progression from the in situ stage to the invasive stage. Lesser procedures can be endorsed for those patients of advanced age or who have associated medical problems whose life expectancy is estimated to be 10 years or less. Patients who refuse bilateral mastectomy should undergo biopsy of the involved or opposite breast at 3 to 5 year intervals regardless of physical findings or mammographic suspicions, especially when severe epithelial dysplasia is encountered in the biopsy specimens. This nonpalpable but potentially curable lesion remains difficult to detect even by mammography.
我们回顾性分析了1960年至1972年间治疗的112例乳腺原位癌病例，进行了至少10年的随访，以将治疗方法与治疗结果相关联。我们得出结论，双侧单纯乳房切除术加低位腋窝淋巴结清扫术是导管内癌或小叶原位癌的首选治疗方法。这一结论是基于诊断时的年龄较轻、双侧发病率高、潜伏期长以及从原位阶段发展为浸润阶段的可能性。对于年龄较大或伴有预期寿命估计为10年或更短的相关医疗问题的患者，可以采用较小的手术。拒绝双侧乳房切除术的患者应每隔3至5年对受累乳房或对侧乳房进行活检，无论体格检查结果或乳房X线摄影检查结果如何可疑，尤其是当活检标本中出现严重上皮发育异常时。这种触诊不到但可能治愈的病变即使通过乳房X线摄影检查也仍然难以发现。
