目的了解我国乳腺外科医生对于美国外科医师学会肿瘤学组(American College of Surgeons Oncology Group,ACOSOG)Z0011试验的认知情况,分析Z0011试验结果对中国乳腺外科医生外科实践的影响程度。方法通过问卷调查的方式调查中国乳腺外...目的了解我国乳腺外科医生对于美国外科医师学会肿瘤学组(American College of Surgeons Oncology Group,ACOSOG)Z0011试验的认知情况,分析Z0011试验结果对中国乳腺外科医生外科实践的影响程度。方法通过问卷调查的方式调查中国乳腺外科医生对Z0011试验的了解情况以及在知道Z0011试验结果前后对于符合Z0011试验入组标准的乳腺癌患者腋窝处理方式的意见并分析相关因素。结果回馈调查问卷的427位医生中有116人(27.2%)对Z0011试验熟悉,不知道的有122人(28.5%)。在知晓Z0011试验结果的305位医生中,在知晓前后,对于符合Z0011试验入组标准的乳腺癌患者,不倾向于做腋窝淋巴结清扫术(axillary lymph node dissection,ALND)的医生分别为78人(25.6%)和115人(37.7%)。医生所属医院的级别、所在地区、受教育程度、从事专业的时间与医生对Z0011试验了解程度之间都存在显著性关系(P<0.05),而与医生在知道Z0011试验结果之后的外科策略选择之间没有相互性关系(P>0.05)。结论我国乳腺外科医生对Z0011试验的认知程度及接受程度仍较低。展开更多
Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentine...Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentinel lymph node biopsy （SLNB） should be performed in patients with an initial diagnosis of DCIS. Methods： A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axillary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results： Eighty-two patients （66.1%） had pure DCIS and 25 （20.2%） had DCIS with microinvasion （DCISM）, 17 （13.7%） updated to invasive breast cancer （IBC）. 115 patients （92.7%） underwent SLNB, among them, 70 patients （56.5%） underwent axillary node dissection. 3 of 115 patients （2.6%） had a positive sentinel lymph node, only 1 （1.4%） of 70 patients had axillary lymph node metastasis, in 84 patients （66.7%） who were diagnosed DCIS by core needle biopsy （CNB） and vacuum-assisted biopsy （VAB）. 26 patients （31.0%） were upstaged into IBC or DCISM in the final histological diagnosis. The statistically significant factors predictive of underestimation were large tumor size, microcalcifications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion： The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especially in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.展开更多
文摘目的了解我国乳腺外科医生对于美国外科医师学会肿瘤学组(American College of Surgeons Oncology Group,ACOSOG)Z0011试验的认知情况,分析Z0011试验结果对中国乳腺外科医生外科实践的影响程度。方法通过问卷调查的方式调查中国乳腺外科医生对Z0011试验的了解情况以及在知道Z0011试验结果前后对于符合Z0011试验入组标准的乳腺癌患者腋窝处理方式的意见并分析相关因素。结果回馈调查问卷的427位医生中有116人(27.2%)对Z0011试验熟悉,不知道的有122人(28.5%)。在知晓Z0011试验结果的305位医生中,在知晓前后,对于符合Z0011试验入组标准的乳腺癌患者,不倾向于做腋窝淋巴结清扫术(axillary lymph node dissection,ALND)的医生分别为78人(25.6%)和115人(37.7%)。医生所属医院的级别、所在地区、受教育程度、从事专业的时间与医生对Z0011试验了解程度之间都存在显著性关系(P<0.05),而与医生在知道Z0011试验结果之后的外科策略选择之间没有相互性关系(P>0.05)。结论我国乳腺外科医生对Z0011试验的认知程度及接受程度仍较低。
文摘Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentinel lymph node biopsy （SLNB） should be performed in patients with an initial diagnosis of DCIS. Methods： A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axillary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results： Eighty-two patients （66.1%） had pure DCIS and 25 （20.2%） had DCIS with microinvasion （DCISM）, 17 （13.7%） updated to invasive breast cancer （IBC）. 115 patients （92.7%） underwent SLNB, among them, 70 patients （56.5%） underwent axillary node dissection. 3 of 115 patients （2.6%） had a positive sentinel lymph node, only 1 （1.4%） of 70 patients had axillary lymph node metastasis, in 84 patients （66.7%） who were diagnosed DCIS by core needle biopsy （CNB） and vacuum-assisted biopsy （VAB）. 26 patients （31.0%） were upstaged into IBC or DCISM in the final histological diagnosis. The statistically significant factors predictive of underestimation were large tumor size, microcalcifications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion： The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especially in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.
