Mammographic calcification can predict outcome in women with breast cancer treated with breast-conserving surgery.
Mammographic calcification can predict outcome in women with breast cancer treated with breast-conserving surgery.
复制标题
乳房X线照相钙化可以预测接受保乳手术治疗的乳腺癌女性的结果
DOI：
10.3892/ol.2017.6112
复制
发表时间：
2017-07
期刊：
影响因子：
2.9
通讯作者：
Xiao C
中科院分区：
文献类型：
--
作者：
Qi X;Chen A;Zhang P;Zhang W;Cao X;Xiao C
钙化对接受保乳手术（BCS）的乳腺癌患者的影响尚不清楚。本研究的目的是确定乳腺癌钙化患者接受BCS治疗的结果。方法回顾性分析2005年1月至2008年12月409例乳腺癌患者接受BCS治疗的临床资料。患者被分类为有钙化（乳房X线摄影或超声检查）或无钙化（乳房X线摄影或超声检查均无）。比较两组患者的局部无复发生存时间（LRFS）、无病生存时间（DFS）和总生存时间（OS），并根据乳腺钙化的形态学类型和分布模式进行亚组分析。生存分析显示，与无钙化组相比，有钙化组的局部复发、远处转移和死亡风险显著增加[相对危险度（RR）和95%可信区间（CI）分别为：局部复发2.46和1.11-5.44，远处转移2.24和1.19-4.24，局部复发2.46和1.11-5.44，远处转移2.24和1.19-4.24]。死亡率2.50和1.06-5.86]。亚组分析显示，分布模式（而不是形态类型的钙化）占BCS后复发的风险增加。乳腺摄影钙化呈线性/节段性分布的患者LRFS显著降低（RR=6.20; 95% CI，2.26-16.98），DFS（RR=6.81; 95% CI，2.86-16.20）和OS（RR=9.14; 95%CI，2.53-33.00），而乳腺摄影钙化呈簇状分布的患者LRFS没有显著降低，无钙化组与无钙化组相比，DFS和OS无显著性差异（P>0.05）。此外，乳腺摄影钙化沿着导管扩散更可能伴有广泛的导管内成分（P<0.001）。最后，乳腺超声检查有钙化的患者的结局与无钙化的患者一样好。乳腺摄影钙化的患者，特别是钙化沿着导管扩散的患者，BCS后复发的风险较高，这对长期生存有负面影响。乳腺超声检查发现的钙化不影响BCS治疗患者的生存率。
The impact of calcification in patients with breast carcinoma treated with breast-conserving surgery (BCS) is unclear. The present study aimed to determine the outcome of breast cancer patients with calcification treated with BCS. The records of 409 patients with breast carcinoma treated with BCS from January 2005 to December 2008 were reviewed. Patients were categorized as those with calcification (on mammography or ultrasonography), or those without calcification (neither on mammography nor ultrasonography). The local relapse free survival time (LRFS), disease free survival time (DFS) and overall survival time (OS) were compared, and subgroup analysis was performed based on morphological types and distribution patterns of mammographic calcification. Survival analysis demonstrated that patients with calcification had a significantly increased risk of local recurrence, distant metastasis and mortality compared with those without calcification [relative risk (RR) and 95% confidence interval (CI): local recurrence, 2.46 and 1.11–5.44; distant metastasis, 2.24 and 1.19–4.24; mortality, 2.50 and 1.06–5.86]. Subgroup analysis revealed that the distribution patterns (rather than morphological types of calcification) accounted for the increased risk of recurrence following BCS. Patients with mammographic calcification of liner/segmental distribution had significantly decreased LRFS (RR=6.20; 95% CI, 2.26–16.98), DFS (RR=6.81; 95% CI, 2.86–16.20) and OS (RR=9.14; 95% CI, 2.53–33.00), while patients with mammographic calcification of clustered distribution did not have significantly decreased LRFS, DFS and OS (P>0.05), compared with those without calcification. In addition, the mammographic calcification spreading along the ducts was more likely to be accompanied by an extensive intraductal component (P<0.001). Finally, the outcome of patients with calcification on breast ultrasound was as good as those without calcification. Patients with mammographic calcification, particularly those with calcification spreading along the ducts, have a higher risk of recurrence following BCS, which has a negative impact on long-term survival. Calcification identified on breast ultrasonography does not affect the survival of patients treated with BCS.