Salvadori B, Biganzoli E, Veronesi P, Saccozzi R, Rilke F
Istituto di Statistica Medica e Biometria, Università degli Study di Milano, Italy.
Br J Surg. 1997 Jan;84(1):106-9.
Some reports state that infiltrating lobular breast carcinoma (ILC) should not be treated by conservative methods because of a high risk of local recurrence. The aim of this study was to determine whether patients with conservatively treated ILC have a higher risk of intrabreast relapse than those with infiltrating ductal carcinoma (IDC).
Some 286 consecutive patients with ILC of the breast were compared with 1903 women with IDC treated at the Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, over the same interval (1973-1989). Patients in both series received the same treatment: quadrantectomy, complete axillary dissection and radiotherapy to the breast. Adjuvant treatment was administered according to nodal and menopausal status (chemotherapy or tamoxifen). Follow-up lasted until December 1994, with a median of 137 months for patients with ILC and 133 for those with IDC. Histology slides were reviewed to assess the presence of multifocality (ILC 4.5 per cent versus IDC 3.6 per cent and extensive intraduct component (ILC 0.3) per cent versus IDC 6.4 per cent).
No difference in cumulative local recurrence rate was found between the two groups at 10 years (approximately 7 per cent).
Conservative surgery is equally safe for patients with infiltrating lobular or ductal carcinoma of the breast.
一些报告指出，由于局部复发风险高，浸润性小叶乳腺癌（ILC）不应采用保守治疗方法。本研究的目的是确定接受保守治疗的ILC患者与浸润性导管癌（IDC）患者相比，乳腺内复发风险是否更高。
在米兰国立肿瘤研究所，对286例连续的乳腺ILC患者与1903例同期（1973 - 1989年）接受治疗的IDC女性患者进行了比较。两个系列的患者均接受相同的治疗：象限切除术、腋窝淋巴结清扫术及乳腺放疗。辅助治疗根据淋巴结和绝经状态进行（化疗或他莫昔芬）。随访持续至1994年12月，ILC患者的中位随访时间为137个月，IDC患者为133个月。对组织学切片进行复查以评估多灶性的存在情况（ILC为4.5%，IDC为3.6%）以及广泛导管内成分（ILC为0.3%，IDC为6.4%）。
两组在10年时的累积局部复发率无差异（约7%）。
对于乳腺浸润性小叶癌或导管癌患者，保守手术同样安全。
