为探讨乳腺原位癌(DCIS)保守治疗与长期复发率之间的关系,美国亚利桑那医学院外科对分别采用乳房切除术、单一肿瘤广泛切除术和肿瘤广泛切除术加放疗治疗的124例DCIS进行了对比分析研究.124例DCIS病人诊断时年龄为33～87岁,平均60岁,98例系绝经后,26例为绝经前.75例(60%)采用乳房切除术,28例(23%)采用单一广泛切除术,21例(17%)采用广泛切除加术后放疗.乳房切除术的75例中,33例(44%)肿瘤边缘清楚,11例(15%)边缘受累,31例(41%)边缘不清.29例(39%)为粉刺型DCIS,31例(41%)为非粉刺型DCIS,15例(20%)组织学亚型未确定.该组平均随访47个月,仅1例手术后第59个月复发,复发时诊断为腺癌,因其既往曾做过改良根治乳房切除术,故复发后加用局部放疗32天,于放疗后37个月时死于充血性心衰,但肿瘤已不存在.单一肿块广泛切除术的28例病人中,17例(61%)肿瘤边缘清楚,1例(3%)边缘受累,10例(36%)边缘不清.11例(39%)为粉刺型DCIS,8例(29%)为非粉刺型DLCIS,9例(32%)亚型未 To explore the relationship between conservative treatment of breast cancer in situ (DCIS) and long-term recurrence rate, the Department of Surgery of Arizona Medical University performed 124 cases of DCIS with mastectomy, extensive single tumor resection, and extensive tumor resection plus radiotherapy. In a comparative analysis study, 124 patients with DCIS were diagnosed at 33 to 87 years of age, with an average age of 60 years, 98 cases were postmenopausal, 26 cases were premenopausal, 75 cases (60%) were treated with mastectomy, and 28 cases (23%). ) Using a single extensive resection, 21 cases (17%) used extensive resection plus postoperative radiotherapy. Of the 75 patients undergoing mastectomy, 33 (44%) had clear tumor margins, 11 (15%) marginal involvement, and 31 cases. (41%) The margins were unclear. 29 (39%) were acne DCIS, 31 (41%) were nonacne DCIS, and 15 (20%) histological subtypes were not confirmed. The group had an average of 47 follow-up visits. Month, only one case relapsed at 59 months after surgery. At the time of recurrence, it was diagnosed as adenocarcinoma. Because it had previously undergone modified radical mastectomy, it was treated with local radiotherapy for 32 days after relapse and died at 37 months after radiotherapy. In congestive heart failure, but the tumor is no longer present. Of the 28 patients with extensive resection of a single mass, 17 (61%) had clear margins of the tumor, 1 (3%) marginal involvement, and 10 (36%) margins. Qing .11 (39%) as a comedo DCIS, 8 patients (29%) non-comedo DLCIS, 9 cases (32%) non-subtype