Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China; Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China; Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
J Surg Res. 2021 May;261:400-406. doi: 10.1016/j.jss.2020.12.049. Epub 2021 Jan 23.
Recent studies suggest that desmoid tumors can be managed more conservatively rather than undergoing wide surgical resection (SR). Ultrasound-guided vacuum-assisted biopsy (UGVAB) is a minimally invasive technique. This retrospective study aimed to compare the outcome in patients with breast desmoid tumor (BDT) who received UGVAB alone versus SR.
The pathology database was searched for patients diagnosed with BDT ≤ 3 cm from 2007 to 2019. All patients underwent breast ultrasound examination and were then performed UGVAB alone or local SR. The Kaplan-Meier method with a log-rank test was used as a univariate analysis to compare the relapse-free survival (RFS) rates between UGVAB and SR groups. Cox regression analysis was used for multivariate analysis.
A total of 39 patients were included. The median follow-up was 41 mo (range, 5-110 mo). The incidence of tumor recurrence was 23.1% (9/39). The 3-y cumulative RFS was 83.1% and 95.8% in the UGVAB and SR group, respectively, which was not significantly different between the two groups (P = 0.131, log-rank test). Multivariate analysis also revealed that treatment strategy (UGVAB versus SR) was not associated with an increased risk of relapse events (P = 0.274).
Small desmoid tumors (≤3 cm) after UGVAB alone did not have a significantly compromised RFS compared with those who underwent SR. UGVAB may be an alternative and relatively conservative method for the diagnosis and local control of BDT with a smaller size. A prospective, randomized study with large sample size is needed to confirm this observation.
最近的研究表明，与广泛的手术切除（SR）相比，纤维瘤病可以更保守地治疗。超声引导下真空辅助活检（UGVAB）是一种微创技术。本回顾性研究旨在比较接受 UGVAB 单独治疗与 SR 的乳腺纤维瘤病（BDT）患者的结果。
从 2007 年至 2019 年，在病理数据库中搜索诊断为≤3cm 的 BDT 患者。所有患者均行乳腺超声检查，然后单独行 UGVAB 或局部 SR。采用 Kaplan-Meier 方法和对数秩检验进行单因素分析，比较 UGVAB 和 SR 组之间的无复发生存率（RFS）。采用 Cox 回归分析进行多因素分析。
共纳入 39 例患者。中位随访时间为 41 个月（范围，5-110 个月）。肿瘤复发率为 23.1%（9/39）。UGVAB 和 SR 组的 3 年累积 RFS 分别为 83.1%和 95.8%，两组间无显著差异（P=0.131，对数秩检验）。多因素分析还显示，治疗策略（UGVAB 与 SR）与复发事件风险增加无关（P=0.274）。
单独 UGVAB 治疗后，小的纤维瘤病（≤3cm）的 RFS 与 SR 相比没有明显降低。UGVAB 可能是一种替代方法，对于较小的 BDT，是一种相对保守的诊断和局部控制方法。需要进行前瞻性、随机研究，以确认这一观察结果。
