Status of Intraductal Therapy for Ductal Carcinoma in Situ.
Status of Intraductal Therapy for Ductal Carcinoma in Situ.
复制标题
DOI：
10.1007/s12609-010-0015-3
复制
发表时间：
2010-06
影响因子：
0.9
通讯作者：
Hwang, E Shelley
中科院分区：
文献类型：
--
作者：
Flanagan, Meghan;Love, Susan;Hwang, E Shelley
导管内入路在导管原位癌（DCIS）的情况下特别有吸引力，DCIS是一种浸润前的乳腺肿瘤，其范围被认为完全是导管内的。基于对导管系统解剖结构的新认识，以及利用导管内入路的新技术，研究人员正在积极探索导管灌洗、导管镜检查和导管内输注治疗药物如何提高乳腺癌的治疗效果。细胞学和分子诊断都在不断改进，尽管病变导管的最佳靶向仍然是一个重要的考虑因素，但仍在继续寻找DCIS和癌症最有效的诊断生物标志物。导管镜在发现隐性导管内病变方面具有潜力，导管镜引导下的乳房肿瘤切除术可以增加更全面手术切除的可能性。令人兴奋的初步研究正在进行中，以确定导管内化疗输注的安全性和可行性。这些研究是未来研究导管内消融治疗DCIS的重要起点，因为随着我们的知识和技术的发展，DCIS可能是最适合导管内治疗的目标。如果这些研究取得成功，这些方法将使诊断为DCIS的妇女的治疗选择发生重要而有意义的转变。
The intraductal approach is particularly appealing in the setting of ductal carcinoma in situ (DCIS), a preinvasive breast neoplasm that is thought to be entirely intraductal in its extent. Based on an emerging understanding of the anatomy of the ductal system as well as novel techniques to leverage the access accorded by the intraductal approach, researchers are actively exploring how ductal lavage, ductoscopy, and intraductal infusion of therapeutic agents may enhance breast cancer treatment. Both cytologic and molecular diagnostics continue to improve, and work is ongoing to identify the most effective diagnostic biomarkers for DCIS and cancer, although optimal targeting of the diseased duct remains an important consideration. Ductoscopy holds potential in detection of occult intraductal lesions, and ductoscopically guided lumpectomy could increase the likelihood of a more comprehensive surgical excision. Exciting pilot studies are in progress to determine the safety and feasibility of intraductal chemotherapy infusion. These studies are an important starting point for future investigations of intraductal ablative therapy for DCIS, because as our knowledge and techniques evolve, it is likely that DCIS may be the target most amenable to treatment by intraductal therapy. If such studies are successful, these approaches will allow an important and meaningful transformation in treatment options for women diagnosed with DCIS.