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非浸润性乳腺癌患者的预后。

Outcomes in patients with non-invasive breast carcinoma.

机构信息

Department of Breast Surgery, Hiroshima Mark Clinic, Hiroshima, Japan.

Department of Breast Surgery, Hiroshima City Hospital, Hiroshima, Japan.

出版信息

Cancer Rep (Hoboken). 2023 Apr;6(4):e1768. doi: 10.1002/cnr2.1768. Epub 2022 Dec 9.

Abstract

BACKGROUND AND AIM

Non-invasive breast carcinoma is considered to be localized disease and is distinguished from invasive ductal and lobular carcinomas. The local recurrence of non-invasive carcinoma after surgery may lead to development of invasive carcinoma and promote distant metastasis, which worsens the prognosis for breast cancer mortality. The distant metastasis of non-invasive carcinoma may involve the ductal microvasculature without invasion. The outcomes of non-invasive breast carcinoma were examined in this retrospective cohort study.

METHODS AND RESULTS

Of 872 primary breast cancers diagnosed at a single center between May 2008 and March 2022, 93 (10.6%) were found to be non-invasive carcinomas and were examined in this study. The breast cancer recurrence and survival rates of patients with non-invasive carcinoma were analyzed retrospectively. The median follow-up period was 1891 (range, 5-4804) days. All patients underwent surgical treatment [mastectomy with sentinel lymph node biopsy (SLNB) and partial mastectomy with or without SLNB, tumorectomy, and microdochectomy]. Postoperatively, radiation therapy was administered to 73 (78.4%) of the patients and endocrine therapy was administered to 64 (81.0%) of 79 patients with hormone-receptor positivity. Of 26 patients who underwent partial mastectomy with SLNB, 24 (92.3%) showed isolated tumor cells in the SLNs on one-step nucleic acid amplification. Local recurrence was observed in three (0.3%) patients; no distant metastasis was observed. One patient died of a noncancerous disease. The overall survival rate was 98.0% and the breast cancer-specific survival rate was 100.0%.

CONCLUSIONS

Non-invasive breast carcinoma, like invasive breast carcinoma, causes local recurrence, but has a good prognosis without distant metastasis. The clinical significance of isolated tumor cells in the SLNs as a systemic component of non-invasive breast carcinoma remains to be elucidated.

摘要

背景与目的

非浸润性乳腺癌被认为是局限性疾病,与浸润性导管癌和小叶癌不同。手术后非浸润性癌的局部复发可能导致浸润性癌的发展,并促进远处转移,从而使乳腺癌死亡率的预后恶化。非浸润性癌的远处转移可能涉及导管微血管而不发生浸润。本研究回顾性研究了非浸润性乳腺癌的结局。

方法与结果

在 2008 年 5 月至 2022 年 3 月期间,在一家单中心诊断的 872 例原发性乳腺癌中,有 93 例(10.6%)为非浸润性癌,并在本研究中进行了检查。回顾性分析了非浸润性癌患者的乳腺癌复发和生存情况。中位随访时间为 1891 天(范围 5-4804 天)。所有患者均接受手术治疗[乳房切除术伴前哨淋巴结活检(SLNB)和部分乳房切除术伴或不伴 SLNB、肿瘤切除术和微切除术]。术后,73 例(78.4%)患者接受了放射治疗,64 例(81.0%)激素受体阳性患者接受了内分泌治疗。在接受 SLNB 部分乳房切除术的 26 例患者中,24 例(92.3%)在一步核酸扩增中 SLN 中显示孤立肿瘤细胞。3 例(0.3%)患者出现局部复发;无远处转移。1 例患者死于非癌症疾病。总生存率为 98.0%,乳腺癌特异性生存率为 100.0%。

结论

非浸润性乳腺癌与浸润性乳腺癌一样会引起局部复发,但无远处转移,预后良好。SLN 中孤立肿瘤细胞作为非浸润性乳腺癌全身成分的临床意义仍有待阐明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ad8/10075290/1922a2a096db/CNR2-6-e1768-g001.jpg

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