Frykberg E R, Bland K I
Department of Surgery, University of Florida Health Science Center, Jacksonville 32209.
World J Surg. 1994 Jan-Feb;18(1):45-57. doi: 10.1007/BF00348191.
In situ breast carcinoma represents an early localized stage in the transition to invasive breast carcinoma and has an especially favorable prognosis with appropriate management. The widespread use of mammography has contributed to its increased rate of diagnosis. The two histologic forms of this entity have distinct pathologic and biologic characteristics, with different therapeutic implications. Lobular carcinoma in situ is considered a marker of increased risk for subsequent invasive carcinoma and is most commonly managed by nonoperative surveillance. Ductal carcinoma in situ behaves more as a true anatomic precursor of invasive disease and has the same therapeutic options as invasive breast carcinoma. Minimally invasive breast carcinoma should be considered a fundamentally different entity, primarily because of its potential for systemic metastasis that in situ lesions do not theoretically have. There are still many outstanding issues and dilemmas to be resolved by scientific investigation before the intriguing potential of these early forms of breast malignancy are fully understood.
原位乳腺癌是向浸润性乳腺癌转变的早期局部阶段，通过适当的治疗，其预后特别良好。乳腺钼靶摄影的广泛应用导致其诊断率上升。该实体的两种组织学形式具有不同的病理和生物学特征，具有不同的治疗意义。小叶原位癌被认为是后续浸润性癌风险增加的标志物，最常通过非手术监测进行管理。导管原位癌更像是浸润性疾病真正的解剖学前驱，具有与浸润性乳腺癌相同的治疗选择。微浸润性乳腺癌应被视为一种根本不同的实体，主要是因为它具有发生全身转移的可能性，而原位病变理论上没有这种可能性。在充分了解这些早期乳腺癌恶性肿瘤的潜在有趣特性之前，仍有许多突出问题和困境有待通过科学研究来解决。
