Noguchi M, Katev N, Miyazaki I
Department of Surgery (II), Kanazawa University Hospital, Takara-machi, Japan.
Int Surg. 1996 Jul-Sep;81(3):309-15.
Patient selection is an important consideration in breast-conserving therapy (BCT), and is dependent on the clinical and histologic determination of disease extent. In order to provide adequate local control without compromising cosmetic outcome, the amount of breast tissue that must be excised in BCT needs to be individualized. Nuclear magnetic resonance (NMR) imaging can provide better information than mammography or ultrasonography for assessing multifocal and multicentric disease in the breast. However, they will play a limited role in breast cancer staging until NMR imaging-directed sterotaxic biopsy becomes available. On the other hand, the histologic status of the surgical margins as well as certain features of the tumor including the presence of intraductal components is predictive of the extent of breast cancer. It is reasonable to evaluate and obtain clear margins when performing BCT. However, further investigation of new preoperative imaging and intraoperative staging modalities for assessing multifocal and multicentric disease is necessary.
患者选择是保乳治疗（BCT）中的一个重要考量因素，且取决于对疾病范围的临床和组织学判定。为了在不影响美容效果的情况下实现充分的局部控制，BCT中必须切除的乳腺组织量需要个体化。在评估乳腺多灶性和多中心性疾病方面，核磁共振（NMR）成像比乳房X线摄影或超声检查能提供更好的信息。然而，在核磁共振成像引导下的立体定向活检可用之前，它们在乳腺癌分期中的作用将较为有限。另一方面，手术切缘的组织学状态以及肿瘤的某些特征（包括导管内成分的存在）可预测乳腺癌的范围。在进行BCT时评估并获得清晰切缘是合理的。然而，有必要进一步研究用于评估多灶性和多中心性疾病的新的术前成像和术中分期方法。
