Department of Epidemiology, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands; Breast Clinic Oost-Nederland, Ziekenhuis Groep Twente, Hengelo, The Netherlands.
Institute Verbeeten, Tilburg, The Netherlands.
Breast. 2018 Dec;42:3-9. doi: 10.1016/j.breast.2018.07.007. Epub 2018 Jul 18.
The aim of this study was to analyse the efficacy of breast-conserving therapy (BCT) for women with primary DCIS in a population-based setting.
Data were used from five Radiotherapy centres in The Netherlands from 2000 to 2010, all treated with BCT. Of all the cases, 59.2% received a boost of radiotherapy after their whole breast irradiation (WBI), irrespective of margin status.
A total of 1248 cases with primary DCIS were analysed. The 10-years LRFS was 92.9%. Age ≤50 years and a positive margin were significantly related to local relapse free survival (LRFS). Having a boost had no impact on LRFS, showing a nearly equal recurrence pattern in patients with and without a boost. Separate analyses were done on patients who had received and not received a boost of radiotherapy after WBI. We noted 9.1% contra-lateral breast tumours. The 10-years disease specific survival (DSS) rate was 99.0%.
DCIS of the breast and treated with BCT results in excellent LRFS and DSS. Primary surgical lumpectomy with negative margins followed by WBI seems to be the treatment of choice in DCIS treated with BCS with respect to IBTR.
本研究旨在分析在基于人群的环境中，保乳疗法（BCT）治疗原发性乳腺导管原位癌（DCIS）女性的疗效。
本研究使用了荷兰 5 个放疗中心的数据，这些患者均接受了 BCT 治疗。所有患者中，59.2%在全乳照射（WBI）后接受了放疗加量，而不论切缘状态如何。
共分析了 1248 例原发性 DCIS 患者。10 年局部无复发生存率（LRFS）为 92.9%。年龄≤50 岁和阳性切缘与局部无复发生存显著相关。加量放疗对 LRFS 没有影响，提示加量组和不加量组的复发模式几乎相同。我们对接受和未接受 WBI 后加量放疗的患者分别进行了分析。我们发现 9.1%的患者发生了对侧乳腺肿瘤。10 年疾病特异性生存率（DSS）为 99.0%。
乳腺 DCIS 采用 BCT 治疗可获得良好的 LRFS 和 DSS。对于接受 BCS 治疗的 DCIS 患者，原发手术切除加阴性切缘后行 WBI 似乎是 IBTR 的治疗选择。
