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众多的回顾性及前瞻性研究表明,结合放疗的保留乳房手术治疗1、Ⅱ期浸润性乳腺癌的结果和乳房切除术相似,前者手术方式包括肿块切除和1/4乳腺切除术(象限切除术).门诊活检术后复发的危险性增加,放疗开始前原发肿瘤部位必须再行切除,其中残存肿瘤的发生率达32%～62%.本研究的目的在于分析再切除标本中残存肿瘤的临床、放射学及病理学的有关因素,期望有助于指导初始手术的范围以及是否需要行再次切除.研究对象为420例Ⅰ、Ⅱ期乳腺癌病人,其中Ⅰ期病人占78%.病人中位年龄为51岁.分析的相关因素包括种族、临床肿瘤大小、初始切除边缘、确诊时年龄、检出肿瘤的方法、腋淋巴结状况、组织学表现以及EIC(广泛的导管内成分)出现情况.通过单变量和多变量因素分析预测再切除标本中残存肿瘤系非浸润性或浸润性及其切缘阳性的可能性.
Numerous retrospective and prospective studies have shown that the results of combined breast cancer treatment and stage II invasive breast cancer combined with radiotherapy are similar to those of mastectomy. The former surgical methods include lumpectomy and 1/4 mastectomy (resection of the quadrant). The risk of recurrence after an outpatient biopsy is increased. The primary tumor site must be removed before radiotherapy, and the incidence of residual tumors is 32% to 62%. The purpose of this study is to analyze the residual tumor in re-excision specimens. Factors related to clinical, radiological and pathological conditions are expected to help guide the scope of the initial surgery and whether it is necessary to perform re-excision. The study participants were 420 stage I and II breast cancer patients, of whom stage I patients accounted for 78%. The age of 51 years old was analyzed. Related factors included race, clinical tumor size, initial margin of resection, age at diagnosis, method of detecting tumor, axillary lymph node status, histological appearance, and appearance of EIC (extensive intraductal component). The univariate and multivariate factor analysis were used to predict the likelihood of non-invasive or invasive and positive margins in re-excised specimens.