Haga S, Makita M, Shimizu T, Watanabe O, Imamura H, Kajiwara T, Fujibayashi M
Department of Surgery, Tokyo Women's Medical College Daini Hospital, Japan.
Surg Today. 1995;25(4):329-33. doi: 10.1007/BF00311255.
From 1989 to 1991, 24 patients with invasive ductal carcinoma underwent simulated lumpectomy at Tokyo Women's Medical College Daini Hospital. The mastectomy specimens were then examined histopathologically in serial sections for the presence of residual tumors or multicentricity. Lumpectomy specimens from cancer foci at resected margins were also examined. In this study, 23 of 24 patients demonstrated positive resection margins (95.8%). Residual tumors were found in mastectomy specimens from 16 patients (66.7%); unilateral multifocal carcinomas were found in 2 of these patients (8.3%). The incidence and severity of residual tumors did not correlate with primary tumor size or the distance between the nipple and the primary tumor but directly correlated with the severity of intraductal spread of the primary tumor. Tumors with central necrosis were associated with a higher incidence of residual tumors. Our study thus indicates that there is a high risk that some residual tumor will be left in the conserved breast when lumpectomy is performed. Multifocal carcinoma and tumors showing severe intraductal spread and central necrosis are thus associated with extensive residual tumors and are likely to cause local recurrence.
1989年至1991年，24例浸润性导管癌患者在东京女子医科大学第二医院接受了模拟乳房肿瘤切除术。随后对乳房切除术标本进行连续切片的组织病理学检查，以确定是否存在残留肿瘤或多中心性。还对切除边缘癌灶的乳房肿瘤切除术标本进行了检查。在本研究中，24例患者中有23例切缘阳性（95.8%）。在16例患者（66.7%）的乳房切除术标本中发现了残留肿瘤；其中2例患者（8.3%）发现单侧多灶性癌。残留肿瘤的发生率和严重程度与原发肿瘤大小或乳头与原发肿瘤之间的距离无关，但与原发肿瘤导管内扩散的严重程度直接相关。伴有中央坏死的肿瘤残留肿瘤的发生率较高。因此，我们的研究表明，进行乳房肿瘤切除术后，保留的乳房中很可能会残留一些肿瘤。多灶性癌以及表现出严重导管内扩散和中央坏死的肿瘤与广泛的残留肿瘤相关，很可能导致局部复发。
