乳腺浸润性导管癌伴广泛导管内癌成分对保乳术后局部复发的影响

Effect of breast invasive ductal carcinoma with extensive intraductal components on local recurrence after breast conserving surgery

目的 分析乳腺浸润性导管癌伴广泛导管内癌成分(extensive intraductal components,EIC)患者临床病理特征及预后因素.方法 回顾性分析我院接受保乳手术的182例早期乳腺浸润性导管癌患者的临床资料,比较EIC阳性(n=23)和EIC阴性(n=159)两组乳腺癌患者的临床病理特征及预后.结果 在EIC阳性组,同侧乳腺内局部复发率为21.7% (5/23),远处转移率为4.3%(1/23);在EIC阴性组,同侧乳腺局部复发率为1.9% (3/159),远处转移率为3.8% (6/159).EIC阳性组的5年无局部复发率低于EIC阴性组(78.0%比97.7%,P<0.001),差异有统计学意义,而两组的5年无远处转移率相似(95.7%比96.2%,P=0.892),差异无统计学意义.COX多因素分析显示EIC是影响乳腺浸润性导管癌患者保乳手术后局部复发的独立危险因素.结论 广泛导管内癌成分会增加乳腺浸润性导管癌患者的乳腺内局部复发率.

Objective To analyze the clinicopathological features and prognostic factors of patients with breast invasive ductal carcinoma with extensive intraductal components (EIC).Methods The clinical data of 182 patients of early breast invasive ductal carcinoma undergoing breast-conserving surgery were analyzed retrospectively in the Second Affiliated Hospital of Soochow University,and the clinicopathological features and prognosis of two groups of breast cancer patients with EIC positive (n =23) and EIC negative (n =159) were compared.Results In the EIC positive group,ipsilateral breast tumor recurrence (IBTR) was 21.7% (5/23) and the distant metastasis rate was 4.3% (1/23);in the EIC negative group,ipsilateral breast tumor recurrence (IBTR) was 1.9% (3/159) and the distant metastasis rate was 3.8% (6/159).The Kaplan-Meier curve showed that the 5-year local recurrence-free survival rates in the EIC positive group was lower than that of the EIC negative group (78% vs.97.7%) (P < 0.001),and the difference was statistically significant,but the 5-year distant metastasis-free survival rates in the two groups was similar (95.7% vs.96.2%) (P =0.892).COX multivariate analysis showed that EIC was an independent risk factor for local recurrence after breast-conserving surgery in breast invasive ductal carcinoma patients.Conclusions EIC increases the local recurrence rate in patients with breast invasive ductal carcinoma undergoing breast-conserving surgery.