Braasch Maxwell C, Amin Amanda L, Balanoff Christa R, Wagner Jamie L, Larson Kelsey E
School of Medicine, The University of Kansas Health System, Kansas City, KS, USA.
Division of Breast Surgery, Department of Surgery, The University of Kansas Health System, Kansas City, KS, USA.
Breast Cancer (Auckl). 2022 Mar 7;16:11782234211070217. doi: 10.1177/11782234211070217. eCollection 2022.
Women with lobular carcinoma in-situ (LCIS) have an increased risk for developing breast cancer (BC) compared with the general population. However, little is known about the clinical implication of diagnosing LCIS concurrently with an invasive breast cancer. We aimed to define the rate of LCIS diagnosed concurrently with an invasive breast cancer and investigate the risk of contralateral breast cancer (CBC) during survivorship care.
A single center retrospective review over 6 years identified women with stage I-III BC who underwent lumpectomy or unilateral mastectomy. Patients with or without concurrent LCIS were compared using Chi-squared analyses to assess for differences in clinicopathologic factors and risk of future CBC (including invasive and in-situ disease).
Of 1808 patients, 16.6% (n = 301) had LCIS concurrent with their index breast cancer. Patients with LCIS had a higher rate of subsequent CBC development than those without LCIS (3.3% versus 1.0%, = .004). The risk ratio for patients with LCIS developing subsequent CBC compared with those without LCIS was 3.3 (95% confidence interval [CI]: 1.5-7.3).
Patients with LCIS diagnosed concurrently with their index breast cancer at surgery are at higher risk for subsequent CBC than those without LCIS. The evidence from this study suggest that it may be appropriate for women with LCIS diagnosed alongside an index breast cancer to consider on-going high-risk screening during survivorship care.
与普通人群相比，小叶原位癌（LCIS）女性患乳腺癌（BC）的风险增加。然而，对于同时诊断出LCIS和浸润性乳腺癌的临床意义知之甚少。我们旨在确定同时诊断出LCIS和浸润性乳腺癌的发生率，并调查生存护理期间对侧乳腺癌（CBC）的风险。
对一个中心6年期间进行的回顾性研究，纳入接受保乳手术或单侧乳房切除术的I-III期BC女性患者。使用卡方分析比较有无合并LCIS的患者，以评估临床病理因素和未来CBC风险（包括浸润性和原位疾病）的差异。
在1808例患者中，16.6%（n = 301）在其原发性乳腺癌同时合并LCIS。合并LCIS的患者后续发生CBC的比率高于未合并LCIS的患者（3.3%对1.0%，P = 0.004）。合并LCIS的患者与未合并LCIS的患者相比，后续发生CBC的风险比为3.3（95%置信区间[CI]：1.5 - 7.3）。
手术时原发性乳腺癌同时诊断出LCIS的患者比未合并LCIS的患者后续发生CBC的风险更高。本研究的证据表明，原发性乳腺癌同时诊断出LCIS的女性在生存护理期间考虑持续进行高危筛查可能是合适的。
