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与浸润性乳腺癌同时诊断出的小叶原位癌(LCIS)的预后意义。

Prognostic Significance of Lobular Carcinoma In-Situ (LCIS) Diagnosed Alongside Invasive Breast Cancer.

作者信息

Braasch Maxwell C, Amin Amanda L, Balanoff Christa R, Wagner Jamie L, Larson Kelsey E

机构信息

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.

出版信息

Breast Cancer (Auckl). 2022 Mar 7;16:11782234211070217. doi: 10.1177/11782234211070217. eCollection 2022.

Abstract

PURPOSE

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.

MATERIALS AND METHODS

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).

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

材料与方法

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。

结果

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)。

结论

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。

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High-Risk Breast Lesions and Current Management.高危乳腺病变与当前治疗方法
Semin Roentgenol. 2018 Oct;53(4):252-260. doi: 10.1053/j.ro.2018.08.001. Epub 2018 Aug 31.
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Diagnosis and Management of High-Risk Breast Lesions.高危乳腺病变的诊断与管理。
J Natl Compr Canc Netw. 2018 Nov;16(11):1391-1396. doi: 10.6004/jnccn.2018.7099.
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Lobular Carcinoma In Situ.小叶原位癌
Surg Pathol Clin. 2018 Mar;11(1):123-145. doi: 10.1016/j.path.2017.09.009. Epub 2017 Dec 8.

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