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腺瓣技术在乳腺导管原位癌手术治疗中的疗效与安全性

Efficacy and Safety of Glandular Flap Techniques in Surgical Treatment of Large Ductal Carcinoma in situ.

作者信息

Dogan Lutfi, Gulcelik Mehmet Ali

机构信息

Department of General Surgery, University of Health Sciences, Ankara Oncology Training and Research Hospital, Ankara, Turkey.

Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey.

出版信息

Breast Care (Basel). 2021 Jun;16(3):263-268. doi: 10.1159/000507502. Epub 2020 May 27.

Abstract

BACKGROUND

It is well known that full segmentary resection can be performed using oncoplastic surgery (OPS) techniques, and the anatomic resection of the ductal system is possible. Therefore, the efficacy and safety of OPS should be investigated in the treatment of ductal carcinoma in situ (DCIS).

PATIENTS AND METHODS

Patients who were diagnosed as pure DCIS and underwent surgical treatment and follow-up were retrospectively evaluated. Patients who underwent OPS and conventional breast-conserving surgery (BCS) were included in the study. The number of patients who required an intervention after the surgery and had a relapse during the follow-up period was determined in both groups.

RESULTS

There were 45 patients in the OPS group and 138 patients in the BCS group. The mean tumor size was larger in patients in the OPS group (36 ± 12 mm vs. 24 ± 8 mm, = 0.02). Six (12.7%) patients were reoperated in the OPS group. Of these, 4 were re-excisions and 2 were mastectomies. In this group, breast conservation was possible in 45 (95.7%) patients. Thirty-nine (27%) patients were reoperated in the BCS group. Of these, 23 were re-excisions, and 16 were mastectomies. In this group, breast conservation was possible in 126 (88.7%) patients ( = 0.02). There was no significant difference between the groups in terms of 5-year cumulative local recurrence rates. While the 5-year local recurrence-free survival rate was 93.3% in the OPS group, it was 90.8% in the BCS group.

CONCLUSION

This study provided evidence that OPS can be used safely in the surgical treatment of DCIS by reducing re-excision and completion mastectomy rates compared to BCS.

摘要

背景

众所周知,使用肿瘤整形手术(OPS)技术可以进行全节段切除,并且导管系统的解剖切除是可行的。因此,应研究OPS在治疗导管原位癌(DCIS)中的疗效和安全性。

患者与方法

对诊断为单纯DCIS并接受手术治疗及随访的患者进行回顾性评估。纳入接受OPS和传统保乳手术(BCS)的患者。确定两组中术后需要干预且在随访期间复发的患者数量。

结果

OPS组有45例患者,BCS组有138例患者。OPS组患者的平均肿瘤大小更大(36±12mm对24±8mm,P = 0.02)。OPS组有6例(12.7%)患者接受了再次手术。其中,4例为再次切除,2例为乳房切除术。在该组中,45例(95.7%)患者可以保乳。BCS组有39例(27%)患者接受了再次手术。其中,23例为再次切除,16例为乳房切除术。在该组中,126例(88.7%)患者可以保乳(P = 0.02)。两组的5年累积局部复发率无显著差异。OPS组的5年无局部复发生存率为93.3%,BCS组为90.8%。

结论

本研究提供了证据,表明与BCS相比,OPS通过降低再次切除率和乳房切除完成率,可安全用于DCIS的手术治疗。

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