浸润性导管乳腺癌患者行保乳手术后手术切缘阳性的影响因素。

Journal of the Korean Surgical Society Pub Date : 2013-03-01 Epub Date: 2013-02-27 DOI:10.4174/jkss.2013.84.3.154
Bulent Koca, Bekir Kuru, Savas Yuruker, Barıs Gokgul, Necati Ozen
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引用次数: 10

摘要

目的:本研究的目的是评估侵袭性导管乳腺癌患者行保乳手术(BCS)术前诊断性核心活检后手术切缘阳性的影响因素。方法:216例ⅰ、ⅱ期浸润性导管性乳腺癌患者经术前真切活检病理诊断并行BCS。分析影响手术切缘阳性的潜在因素。单因素分析中,影响手术切缘阳性的因素采用卡方检验进行比较。采用Logistic回归检验检测影响手术切缘阳性的独立因素。结果:腋窝淋巴结阳性(优势比[OR], 8.2;95%可信区间[CI], 3.01 ~ 22.12),淋巴血管侵袭(LVI;或者,3.9;95% CI, 1.62 ~ 9.24),广泛导管内成分(EIC;或者,6.1;95% CI, 2.30 - 16.00),存在棘刺(OR, 5.1;95% CI, 2.00 - 13.10)或乳房x光检查中存在微钙化(or, 13.7;95% CI(4.04 ~ 46.71)是影响手术切缘阳性的独立不利因素。结论:考虑手术切除程度的决定和BCS前手术切缘阴性,腋窝淋巴结阳性、LVI、EIC、针状增生或微钙化是乳房x线摄影中手术切缘阳性的预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Factors affecting surgical margin positivity in invasive ductal breast cancer patients who underwent breast-conserving surgery after preoperative core biopsy diagnosis.

Purpose: The aim of our study is to evaluate the factors affecting surgical margin positivity among patients with invasive ductal breast cancer who underwent breast-conserving surgery (BCS) after preoperative diagnostic core biopsy.

Methods: Two hundred sixteen patients with stage I, II invasive ductal breast carcinoma who had histological diagnosis with preoperative tru-cut biopsy and underwent BCS were included in the present study. Potential factors that affect the positive surgical margin were analyzed. In univariate analysis, the comparisons of the factors affecting the surgical margin positivity were made by chi-square test. Logistic regression test was used to detect the independent factors affecting the surgical margin positivity.

Results: Positive axillary lymph node (odds ratio [OR], 8.2; 95% confidence interval [CI], 3.01 to 22.12), lymphovascular invasion (LVI; OR, 3.9; 95% CI, 1.62 to 9.24), extensive intraductal component (EIC; OR, 6.1; 95% CI, 2.30 to 16.00), presence of spiculation (OR, 5.1; 95% CI, 2.00 to 13.10) or presence of microcalcification in the mammography (OR, 13.7; 95% CI, 4.04 to 46.71) have been found to be the independent and adverse factors affecting surgical margin positivity.

Conclusion: Considering decision making for the extent of the excision and for achieving negative surgical margin before BCS, positive axillary lymph node, LVI, EIC, spiculation or microcalcification in mammography are related as predictor factors for positive surgical margin.

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