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对侧乳房缩小组织中的乳腺癌

Breast Cancer in the Tissue of the Contralateral Breast Reduction.

作者信息

Kuijlaars Zoë M A, Hillberg Nadine S, Kooreman Loes, Severens Rijvers Carmen A H, Qiu Shan Shan

机构信息

Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands.

Department of Pathology, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands.

出版信息

Cancers (Basel). 2024 Jan 24;16(3):497. doi: 10.3390/cancers16030497.

DOI:10.3390/cancers16030497
PMID:38339249
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10854570/
Abstract

Breast cancer is the most prevalent malignancy among women worldwide, and the increasing number of survivors is due to advances in early diagnosis and treatment efficacy. Consequently, the risk of developing contralateral breast cancer (CBC) among these survivors has become a concern. While surgical intervention with lumpectomy is a widely used primary approach for breast cancer, post-operative breast asymmetry is a potential concern. Many women opt for symmetrizing reduction procedures to improve aesthetic outcomes and quality of life. However, despite careful radiological screening, there is a chance of accidentally finding CBC. To address this, tissue excised during symmetrizing surgery is examined pathologically. In some cases, CBC or in situ lesions have been incidentally discovered in these specimens, prompting a need for a more thorough examination. Resection in pieces and the absence of surgical marking and pathological inking of the margin have made it challenging to precisely identify tumor location and assess tumor size and margin status, hampering adjuvant treatment decisions. A new protocol introduced in July 2022 aims to enhance the precision of CBC diagnosis, allowing for tailored treatment plans, including re-excision, systemic adjuvant therapy, or radiation therapy.

摘要

乳腺癌是全球女性中最常见的恶性肿瘤,幸存者数量的增加归因于早期诊断和治疗效果的进步。因此,这些幸存者中发生对侧乳腺癌(CBC)的风险已成为一个关注点。虽然保乳手术是乳腺癌广泛使用的主要治疗方法,但术后乳房不对称是一个潜在问题。许多女性选择进行对称缩小手术以改善美观效果和生活质量。然而,尽管进行了仔细的放射学筛查,但仍有可能意外发现CBC。为了解决这个问题,对对称手术中切除的组织进行病理检查。在某些情况下,在这些标本中偶然发现了CBC或原位病变,这促使需要进行更彻底的检查。分块切除以及手术切缘缺乏标记和病理墨染使得精确识别肿瘤位置、评估肿瘤大小和切缘状态具有挑战性,从而妨碍辅助治疗决策。2022年7月引入的一项新方案旨在提高CBC诊断的准确性,以便制定个性化的治疗计划,包括再次切除、全身辅助治疗或放射治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b301/10854570/0689ca644cdc/cancers-16-00497-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b301/10854570/1668bfa1f046/cancers-16-00497-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b301/10854570/0689ca644cdc/cancers-16-00497-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b301/10854570/1668bfa1f046/cancers-16-00497-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b301/10854570/0689ca644cdc/cancers-16-00497-g002.jpg

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本文引用的文献

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Time-dependent risk of developing distant metastasis in breast cancer patients according to treatment, age and tumour characteristics.根据治疗、年龄和肿瘤特征,乳腺癌患者发生远处转移的时间依赖性风险。
Br J Cancer. 2014 Mar 4;110(5):1378-84. doi: 10.1038/bjc.2014.5. Epub 2014 Jan 16.
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Body image after bilateral prophylactic mastectomy: an integrative literature review.双侧预防性乳房切除术后的身体意象:一项综合文献综述
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