Jourdain O, Tunon de Lara C, Quenel N, Stöckle E, Bussières E, Faucher A, Acharian V, Vilbas-Guegan C, de Mascarel I, Trojani M, Dilhuydy J M, Avril A
Institut Bergonié, Bordeaux.
J Gynecol Obstet Biol Reprod (Paris). 1998 Jun;27(4):403-12.
To assess the risk of local recurrence of intraductal carcinoma of the breast with a large series and a review of literature.
We present a retrospective study of 331 cases treated for intraductal carcinoma of the breast. Only patients with at least 5 years follow-up were selected. We were specially interested in recurrence risk factors. In these patients with a long follow-up; pathology was reevaluated with new investigation technique.
After a median follow-up of 109 months, 40 local recurrences were observed; these lesions were invasive in 23 cases. Only one patient had recurrence after mastectomy. For the others, they had lumpectomy associated with radiotherapy in 12 cases. Histologic features, grade and therapeutic options were evaluated as risk factors of local recurrence.
Follow-up after lumpectomy for intraductal carcinoma was studied. The status of tumor margins was important; irradiation appeared useful, specially in case of high grade carcinoma but further large prospective randomized studies are needed. The use of prognostic index is interesting, but there are still unanswered questions.
通过大量病例及文献回顾评估乳腺导管内癌局部复发的风险。
我们对331例接受乳腺导管内癌治疗的患者进行了一项回顾性研究。仅选择随访至少5年的患者。我们特别关注复发风险因素。在这些长期随访的患者中,采用新的检查技术对病理进行了重新评估。
中位随访109个月后,观察到40例局部复发;其中23例为浸润性病变。仅1例患者在乳房切除术后复发。其他患者中,12例行肿块切除术并联合放疗。组织学特征、分级及治疗选择被评估为局部复发的风险因素。
对乳腺导管内癌肿块切除术后的随访进行了研究。肿瘤切缘状态很重要;放疗似乎有用,特别是在高级别癌的情况下,但仍需要进一步的大型前瞻性随机研究。预后指数的应用很有意义,但仍存在未解决的问题。