Rosen P P, Braun D W, Lyngholm B, Urban J A, Kinne D W
Cancer. 1981 Feb 15;47(4):813-9. doi: 10.1002/1097-0142(19810215)47:4<813::aid-cncr2820470431>3.0.co;2-j.
This report describes the follow-up of 108 women who underwent ipsilateral mastectomy for lobular carcinoma in situ (LCIS). Twenty-four women found to have concurrent contralateral carcinoma underwent bilateral mastectomy. The contralateral breast was available for follow-up in the remaining 84 cases, including 33 patients who underwent contralateral biopsy and 51 others who did not have a biopsy of the opposite breast at the time of initial treatment. Five of these 84 patients later developed invasive cancer. Three had had a biopsy that revealed either atypia (two cases) or LCIS (one case). In the two other cases, there had not been a prior biopsy. Two of the 26 patients who had had a benign breast biopsy were found to have LCIS, but none subsequently had intraductal or invasive carcinoma, and none of the 26 women died of breast carcinoma. In this series, 64% of the women retained their contralateral breast; deaths due to contralateral breast carcinoma occurred with half the frequency that had been observed in a prior study of women with LCIS who did not have a contralateral biopsy. These results tend to support our current recommendation to treat LCIS by ipsilateral mastectomy and contralateral biopsy. However, it would be necessary to study these patients for approximately ten more years before results can be considered conclusive. Concurrently, prospective controlled investigations should be pursued to confirm these results, to identify patients most at risk in developing invasive carcinoma, and to determine whether nonsurgical therapy can modify the course of LCIS.
本报告描述了108例因小叶原位癌（LCIS）接受同侧乳房切除术的女性的随访情况。24例发现同时患有对侧癌的女性接受了双侧乳房切除术。其余84例患者的对侧乳房可供随访，其中33例患者接受了对侧活检，另外51例在初始治疗时未进行对侧乳房活检。这84例患者中有5例后来发生了浸润性癌。3例活检显示非典型增生（2例）或小叶原位癌（1例）。另外2例之前未进行活检。26例接受过良性乳房活检的患者中有2例被发现患有小叶原位癌，但随后均未发生导管内癌或浸润性癌，且这26例女性中无1例死于乳腺癌。在本系列中，64%的女性保留了对侧乳房；对侧乳腺癌导致的死亡发生率是之前一项对未进行对侧活检的小叶原位癌女性研究中观察到的一半。这些结果倾向于支持我们目前关于通过同侧乳房切除术和对侧活检治疗小叶原位癌的建议。然而，在结果被认为具有决定性之前，有必要对这些患者再进行大约十年的研究。同时，应进行前瞻性对照研究以证实这些结果，确定发生浸润性癌风险最高的患者，并确定非手术治疗是否能改变小叶原位癌的病程。
