Kuru Bekir, Yuruker Savas, Sullu Yurdanur, Gursel Bilge, Ozen Necati
Department of General Surgery, Ondokuz Mayis University School of Medicine, Samsun, Turkey.
Department of Pathology, Ondokuz Mayis University School of Medicine, Samsun, Turkey.
J Invest Surg. 2020 Aug;33(7):627-633. doi: 10.1080/08941939.2018.1539791. Epub 2018 Dec 21.
: Our aim was to determine if a close surgical margin (<2 mm, but no ink on tumor) for ductal carcinoma in situ (DCIS) associated with invasive breast cancer (IBC) leads to an increased rate of ipsilateral breast tumor recurrence (IBTR).: Six hundred and twenty-eight patients with T1-2 IBC who underwent breast conserving therapy (BCT) and had no ink on tumor between 2009 and 2017 in our institution were included in the study. Age, tumor size, axillary lymph node status, resection margin status of DCIS as closer than 2 mm or ≥2 mm, DCIS as present or absent, extensive intraductal component as yes or no were investigated. All patients were followed-up for IBTR.: The median age was 50 years (range, 29-82), and median tumor size was 25 mm (range, 5-50). Median follow-up time was 56 months (range, 12-114). Of the 628 IBC patients, 440 (70%) were found to be associated with DCIS. Of the 440 patients with DCIS, 119 (27%) had a close margin (<2 mm) and 321 (73%) had a margin ≥2 mm for DCIS. Among 440 IBC patients associated with DCIS, there were three local recurrences. One developed in a patient who had a close surgical margin for DCIS, and in the other two patients, surgical margins were ≥2 mm.: No ink on tumor is an adequate margin for IBC associated with DCIS in patients who undergo BCT and it is not associated with increased IBTR.
我们的目的是确定伴有浸润性乳腺癌(IBC)的导管原位癌(DCIS)手术切缘接近(<2毫米,但肿瘤上无墨水标记)是否会导致同侧乳腺肿瘤复发(IBTR)率增加。本研究纳入了2009年至2017年在我院接受保乳治疗(BCT)且肿瘤上无墨水标记的628例T1-2期IBC患者。研究了年龄、肿瘤大小、腋窝淋巴结状态、DCIS的手术切缘状态(切缘小于2毫米或≥2毫米)、DCIS是否存在、是否存在广泛导管内成分。所有患者均随访IBTR情况。中位年龄为50岁(范围29-82岁),中位肿瘤大小为25毫米(范围5-50毫米)。中位随访时间为56个月(范围12-114个月)。在628例IBC患者中,440例(70%)被发现伴有DCIS。在440例伴有DCIS的患者中,119例(27%)DCIS切缘接近(<2毫米),321例(73%)DCIS切缘≥2毫米。在440例伴有DCIS的IBC患者中,有3例局部复发。1例发生在DCIS手术切缘接近的患者中,另外2例患者的手术切缘≥2毫米。对于接受BCT的伴有DCIS的IBC患者,肿瘤上无墨水标记是足够的切缘,且与IBTR增加无关。