Outcome after breast-conserving therapy for patients with stage I or II mucinous, medullary, or tubular breast carcinoma
Outcome after breast-conserving therapy for patients with stage I or II mucinous, medullary, or tubular breast carcinoma
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DOI：
10.1016/j.ijrobp.2003.10.029
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发表时间：
2004-05-01
影响因子：
7
通讯作者：
Recht, A
中科院分区：
文献类型：
--
作者：
Thurman, SA;Schnitt, SJ;Recht, A
目的：评价早期管状、黏液性和髓样乳腺癌患者保乳治疗后首次失败的部位，并与浸润性导管癌（IDC）患者的结果进行比较。方法与材料：临床ⅰ、ⅱ期黏液癌20例，髓样癌27例，小管癌28例，IDC 1055例。最小随访时间为10年。结果：四种组织学类型在治疗后10年内首次失败部位差异无统计学意义（p = 0.15）。剔除IDC肿瘤后，其余三种组织学类型的失败模式差异无统计学意义（P = 0.31）。在多分逻辑模型中，组织学类型与首次失败的部位没有显著相关性（p均为0.17）。局部衰竭与年龄< 50岁（p = 0.04）、手术切缘阳性（p = 0.007）、淋巴血管侵犯（p = 0.04）和广泛导管内肿瘤成分（p < 0.001）显著相关。局部/远端/对侧乳房衰竭与临床T2期肿瘤（p < 0.001）、四个或更多淋巴结阳性（p = 0.004）和淋巴血管浸润阳性肿瘤（p < 0.001）显著相关。第二次恶性肿瘤或死亡与诊断年龄（60岁）和淋巴血管浸润阳性肿瘤（p = 0.03）显著相关。结论：髓质癌、黏液癌、小管癌患者与IDC患者的首次失败部位无统计学差异。虽然没有统计学意义，但我们确实注意到IDC患者长期无病生存率较低的趋势。(C) 2004爱思唯尔公司
Purpose: To evaluate the site of first failure of patients with early-stage tubular, mucinous, and medullary breast carcinoma after breast-conserving therapy and compare their results with those of patients with infiltrating ductal carcinoma (IDC).Methods and Materials: Twenty clinical Stage I and II patients with mucinous carcinoma, 27 with medullary carcinoma, 28 with tubular carcinoma, and 1055 with IDC were identified. The minimal potential follow-up was 10 years.Results: No statistically significant difference (p = 0.15) was seen in the site of first failure between the four histologic types within the first 10 years after treatment. When the IDC tumors were omitted from the comparison, the failure patterns of the remaining three histologic types were not significantly different (P = 0.31). In a polychotomous logistic model, histologic type was not significantly associated with the site of first failure (all p > 0.17). Local failure was significantly associated with age < 50 years (p = 0.04), positive surgical margins (p = 0.007), lymphovascular invasion (p = 0.04), and tumors with an extensive intraductal component (p < 0.001). Regional/distant/opposite breast failure was significantly associated with clinical Stage T2 tumors (p < 0.001), four or more positive lymph nodes (p = 0.004), and lymphovascular invasion-positive tumors (p < 0.001). Second malignancy or death was significantly associated with age at diagnosis >60 years (p < 0.001) and lymphovascular invasion-positive tumors (p = 0.03).Conclusion: No statistically significant difference was noted in the site of first failure between patients with medullary, mucinous, or tubular carcinoma and patients with IDC. Although not statistically significant, we did note a trend toward a lower long-term rate of disease-free survival in patients with IDC. (C) 2004 Elsevier Inc.