Nakhlis Faina, Katlin Fisher D, Grossmith Samantha C, DiPasquale Ashley, Harrison Beth T, Schnitt Stuart J, King Tari A
Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Ann Surg Oncol. 2022 Nov;29(12):7696-7702. doi: 10.1245/s10434-022-12066-2. Epub 2022 Jun 30.
Non-classic lobular carcinoma in situ (NC-LCIS) represents a spectrum of lesions, histologically distinct from classic LCIS (C-LCIS) and ductal carcinoma in situ (DCIS). Several studies have reported on the safety of breast conservation (BCS) in patients with DCIS or invasive breast cancer and concomitant C-LCIS, yet there are no data addressing this question for patients with concomitant NC-LCIS. We evaluated local recurrence (LR) after BCS in patients with DCIS or invasive cancer and concomitant NC-LCIS.
We searched institutional databases using natural language processing to identify patients with DCIS or invasive breast cancer and concomitant NC-LCIS treated with BCS between 2000 and 2015. Charts were reviewed to collect demographics, disease and treatment details, and recurrence events. All results represent descriptive analyses.
We identified 71 patients with DCIS (n = 13) or invasive cancer (n = 58) and concomitant NC-LCIS treated with BCS. Median patient age was 59 years (33-77 years), and median invasive tumor size was 1.2 cm (0.1-6.9 cm); 62% of DCIS and 79% of invasive cancer patients had hormone receptor (HR)-positive disease. Among DCIS patients, seven (54%) received radiation and none hormonal therapy. Among those with invasive cancer, 52 (90%) received radiation, 17 (29%) received chemotherapy and 44 of 55 with HR-positive disease (78%) received hormonal therapy. At median follow-up of 79 months (1-265 months), the LR rate was 8% and 2% among patients with DCIS and invasive cancer, respectively.
NC-LCIS is rarely present in association with DCIS or invasive cancer, and it does not appear to impact LR outcomes following BCS.
非经典小叶原位癌（NC-LCIS）代表一系列病变，在组织学上与经典小叶原位癌（C-LCIS）和导管原位癌（DCIS）不同。多项研究报道了DCIS或浸润性乳腺癌合并C-LCIS患者保乳术（BCS）的安全性，但尚无关于合并NC-LCIS患者这一问题的数据。我们评估了DCIS或浸润性癌合并NC-LCIS患者BCS后的局部复发（LR）情况。
我们使用自然语言处理技术在机构数据库中搜索2000年至2015年间接受BCS治疗的DCIS或浸润性乳腺癌合并NC-LCIS患者。查阅病历以收集人口统计学、疾病和治疗细节以及复发事件。所有结果均为描述性分析。
我们确定了71例接受BCS治疗的DCIS（n = 13）或浸润性癌（n = 58）合并NC-LCIS患者。患者中位年龄为59岁（33 - 77岁），浸润性肿瘤中位大小为1.2 cm（0.1 - 6.9 cm）；62%的DCIS患者和79%的浸润性癌患者为激素受体（HR）阳性疾病。在DCIS患者中，7例（54%）接受了放疗，无人接受激素治疗。在浸润性癌患者中，52例（90%）接受了放疗，17例（29%）接受了化疗，55例HR阳性疾病患者中有44例（78%）接受了激素治疗。中位随访79个月（1 - 265个月），DCIS和浸润性癌患者的LR率分别为8%和2%。
NC-LCIS很少与DCIS或浸润性癌同时出现，且似乎不影响BCS后的LR结局。
