Outcome after invasive local recurrence in patients with ductal carcinoma in situ of the breast
Outcome after invasive local recurrence in patients with ductal carcinoma in situ of the breast
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DOI：
10.1200/jco.1998.16.4.1367
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发表时间：
1998-04-01
影响因子：
45.3
通讯作者：
Waisman, JR
中科院分区：
文献类型：
--
作者：
Silverstein, MJ;Lagios, MD;Waisman, JR
目的：为了详细描述结果，在局部复发，局部浸润性复发，远处复发，和乳腺癌死亡率方面的患者先前治疗的导管原位癌（DCIS.Patients和方法：临床，病理和结果数据收集前瞻性的707例DCIS从1972年至1997年6月累计。39例为非侵袭性（DCIS），35例为侵袭性，51%的侵袭性复发患者表现为1期疾病;其余患者表现为更晚期疾病，乳房切除术后的侵袭性局部复发是一种罕见事件，发生在0.8%的患者中。保乳术后的侵袭性复发更常见，发生在7.4%的患者中。保乳术后8年乳腺癌死亡率为2.1%，随着随访时间的延长，这一数字可能会增加。74例局部复发患者的8年乳腺癌特异性死亡率和远处转移概率分别为8.8%和20.8%。如果仅将35例浸润性复发视为事件，则8年乳腺癌特异性死亡率和远处转移概率分别为14.4%和27.1%。DCIS患者保乳治疗后的浸润性局部复发是一种严重事件，可将先前0期疾病的患者转化为I期至IV期疾病的患者。然而，这些结果表明，大多数局部复发的DCIS患者可以挽救。(C)1998年，美国临床肿瘤学会。
Purpose: To detail the outcome, in terms of local recurrence, local invasive recurrence, distant recurrence, and breast cancer mortality for patients previously treated for ductal carcinoma in situ (DCIS).Patients and Methods: Clinical, pathologic, and outcome data were collected prospectively for 707 patients with DCIS accrued from 1972 through June 1997.Results: There were 74 local recurrences; 39 were noninvasive (DCIS) and 35 were invasive, Fifty-one percent of patients with invasive recurrences presented with stage 1 disease; the remainder presented with more advanced disease, Invasive local recurrence after mastectomy was a rare event that occurred in 0.8% of patients. Invasive recurrence after breast preservation was more common and occurred in 7.4% of patients. The 8-year probability of breast cancer mortality after breast preservation was 2.1%, a number that is likely to increase with longer follow-up. The 8-year breast cancer-specific mortality and distant-disease probability for the subgroup of 74 patients with locally recurrent disease was 8.8% and 20.8%, respectively, If only the 35 invasive recurrences are considered as events, the 8-year breast cancer-specific mortality and distant disease probability was 14.4% and 27.1%, respectively.Conclusion: Invasive local recurrence after breast preservation treatment for patients with DCIS is a serious event that converts patients with previous stage 0 disease to patients with disease that ranges from stage I to stage IV, These results, however, indicate that most DCIS patients with local recurrence can be salvaged. (C) 1998 by American Society of Clinical Oncology.