Bahnsen J, Warneke B, Frischbier H J, Stegner H E
Geburtshilfe Frauenheilkd. 1985 Jul;45(7):488-93. doi: 10.1055/s-2008-1036358.
116 cases of early ductal breast cancer diagnosed during 1971 to 1981 were analysed. In 65 cases no invasion was detectable. 37 cases showed an early stromal invasion and in 14 cases the invasion was questionable. A palpable mass was seen in 32% of the noninvasive and in 46% of the early invasive cases. The most important mammographic signs were grouped, suspicious microcalcifications (87%). Multicentricity occurred in 26% of the noninvasive and 43% of the early invasive cases. Two cases of the noninvasive and two of the early invasive group had axillary metastasis. Positive nodes were seldom in early ductal carcinoma (3%) compared to 42 invasive comedo-carcinomas (36% positive axillary nodes). In the follow-up five local recurrences were detected in the noninvasive group and one each in the other groups. In the noninvasive group 17% local recurrences occurred after breast conserving modalities compared to 4% in mastectomy patients. As no reliable data for the selection and the results of breast preserving modalities are available now, mastectomy and axillary dissection may be the safest therapy. Only in small intraductal breast cancer (under 25 mm) the breast may be conserved (wide excision, segmental resection, quadrantectomy), if complete excision is carefully controlled by mammography and histology and follow-up is guaranteed.
对1971年至1981年期间诊断出的116例早期导管癌病例进行了分析。65例未检测到浸润。37例显示早期间质浸润，14例浸润情况存疑。32%的非浸润性病例和46%的早期浸润性病例可触及肿块。最重要的乳腺X线摄影征象是成簇的可疑微钙化（87%）。多中心性在26%的非浸润性病例和43%的早期浸润性病例中出现。非浸润性组和早期浸润性组各有2例发生腋窝转移。与42例浸润性粉刺癌（36%腋窝淋巴结阳性）相比，早期导管癌腋窝淋巴结阳性很少见（3%）。随访中，非浸润性组发现5例局部复发，其他组各发现1例。在非浸润性组中，保乳治疗后17%发生局部复发，而乳房切除术患者为4%。由于目前尚无关于保乳治疗的选择和结果的可靠数据，乳房切除术和腋窝清扫术可能是最安全的治疗方法。仅对于小的导管内乳腺癌（直径小于25毫米），如果通过乳腺X线摄影和组织学仔细控制完全切除并保证随访，可保留乳房（广泛切除、区段切除、象限切除）。
