A single-center retrospective study on influence factors on surgical methods in DCIS patients
10.3760/cma.j.issn.1674-6090.2019.05.002
- VernacularTitle:单中心回顾性分析乳腺导管原位癌患者外科治疗术式的影响因素
- Author:
Jing SI
1
;
Chenlian QUAN
;
Miao MO
;
Rong GUO
;
Yonghui SU
;
Benlong YANG
;
Jiajian CHEN
;
Zhimin SHAO
;
Jiong WU
Author Information
1. 复旦大学附属肿瘤医院乳腺外科
- Keywords:
Ductal carcinoma in situ;
Surgery therapy;
Breast conservation surgery;
Breast reconstruction
- From:
Chinese Journal of Endocrine Surgery
2019;13(5):357-363
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the influence factors on surgical methods in DCIS (Ductal carcinoma in situ) patients,and the prognosis of different surgical methods in a 10-year single-center retrospective study.Methods We retrospectively included 1557 DCIS patients who received treatments in our center from Jan.2006 to Nov.2016.T tests,Chi-square analysis and logistic regression analysis were used to analyze influence factors on surgical methods.Kaplan-Meier and Log-rank analysis were used to evaluate recurrence-free survival(RFS) and loco-regional recurrence-free survival (LRRFS) in patients with different surgical methods.Results Of the enrolled 1557 DCIS patients,surgical methods included modified radical mastectomy,simple mastectomy (with or without axillary evaluation) and breast conservation surgery (with or without axillary evaluation).The number of DCIS cases in our center increased (P＜0.001),so did the percentage of DCIS in annual malignant surgery cases (P=-0.026).Significant decrease was found in modified radical mastectomy (P=0.012).More than half of the patients received simple mastectomy after 2010,and more than one fifth of the patients received breast conservation surgery after 2008.About 13.99％ patients who received mastectomy had breast reconstruction.The independent influence factors of refusing breast conservation surgery were age ≥ 50(P＜0.001),medium nuclear grade (P=0.044),tumor size ＞ 15mm (P＜0.001) and spontaneous discharge (P＜0.001).Patients with smaller tumor size (≤ 15mm) and no spontaneous discharge had 4.18-fold and 7.04-fold greater preference for breast conservation surgery,respectively(OR=0.232,P＜0.001;OR=0.144,P＜0.001).There were no significant differences in RFS and LRRFS in patients with different surgical methods.Conclusion The evaluation in trends and influence factors of different surgical methods provides basis on surgical precision medicine in DCIS patients.
