Winchester D J, Chang H R, Graves T A, Menck H R, Bland K I, Winchester D P
Evanston Hospital, IL 60201, USA.
J Am Coll Surg. 1998 Apr;186(4):416-22. doi: 10.1016/s1072-7515(98)00051-9.
Compared with invasive ductal carcinoma, invasive lobular carcinoma of the breast is considered by many to be a more indistinct and multicentric form of cancer that is detected later and is treated less optimally by breast-preservation techniques. This study analyzed the presentation, treatment trends, and survival rates of women who had invasive lobular and ductal breast carcinoma. The objective was to determine the utility of breast-preservation therapy for invasive lobular carcinoma by analysis of historic data on tumor features and survival.
Data on 291,273 women diagnosed with invasive carcinoma between 1985 and 1993 were obtained from the National Cancer Data Base. Analysis included the patient's age at diagnosis; tumor histology, anatomic site, diameter, grade, and stage; treatment; and disease status 5 years after diagnosis.
The mean patient age at diagnosis was 61.0 years for invasive ductal carcinoma, 63.0 years for invasive lobular carcinoma, and 60.6 years for tumors with combined histology. The anatomic location, tumor diameter, and tumor grade were similar for each histotype. Breast-preservation therapy was less frequent for invasive lobular carcinoma. The 5-year overall survival and local disease-free survival rates for women treated with breast preservation were similar for invasive ductal carcinoma (84% overall survival; 97% disease-free survival) and invasive lobular carcinoma (87% overall survival; 98% disease-free survival).
Invasive lobular carcinoma presents with a similar age distribution, anatomic subsite, diameter, and grade as invasive ductal carcinoma. Breast preservation is selected less commonly for women who have invasive lobular carcinoma, but this choice of therapy does not compromise the disease-free or overall survival status of this group of patients.
与浸润性导管癌相比，许多人认为乳腺浸润性小叶癌是一种更不明显且多中心的癌症形式，发现较晚，采用保乳技术治疗的效果也不太理想。本研究分析了患有浸润性小叶癌和导管癌的女性的临床表现、治疗趋势和生存率。目的是通过分析肿瘤特征和生存的历史数据来确定保乳治疗对浸润性小叶癌的效用。
从国家癌症数据库中获取了1985年至1993年间诊断为浸润性癌的291273名女性的数据。分析内容包括患者诊断时的年龄；肿瘤组织学、解剖部位、直径、分级和分期；治疗情况；以及诊断后5年的疾病状态。
浸润性导管癌患者诊断时的平均年龄为61.0岁，浸润性小叶癌为63.0岁，组织学混合型肿瘤为60.6岁。每种组织学类型的解剖位置、肿瘤直径和肿瘤分级相似。浸润性小叶癌采用保乳治疗的频率较低。接受保乳治疗的女性，浸润性导管癌的5年总生存率和局部无病生存率分别为84%总生存率和97%无病生存率，浸润性小叶癌为87%总生存率和98%无病生存率，二者相似。
浸润性小叶癌的年龄分布、解剖亚部位、直径和分级与浸润性导管癌相似。浸润性小叶癌女性较少选择保乳治疗，但这种治疗选择不会影响该组患者的无病或总体生存状况。
