Treatment Analysis Of Ductal Carcinoma In Situ: A Report Of 39 Cases

Objective:Retrospective analysis of 39 cases of DCIS(ductal carcinoma in situ) and combined with DCIS which reported in the literature, to explore the necessary of breast-conserving in DCIS treatment,and provide experience to the clinical treatment of DCIS.Methods:First collected the 39 patients with DCIS in the First Affiliated Hospital of Dalian Medical University from January 2003 to March 2009, the total of 39 patients were female. Minimum age was 35 years old, maximum age was 77 years old, the average age was 57 years old. In which 4 cases were between 30 to 39 years old,12 cases were between 40 to 49 years old,7 cases were between 50 to 59 years old,8 cases were between 60 to 69 years,8 cases were 70 years old or more. premenopausal patients werel5 cases and 24 cases were postmenopausal patients. All 39 cases were followed up between 3 months and 6 years and 11 months. Then combined with the literature report, analyze gender, age, initial symptom (starting mass, nipple discharge, nipple discharge mass combined) and clinical laboratory examinations (molybdenum X-ray, ultrasonography, MRI, pathological examination) and treatment (surgery, radiotherapy, chemotherapy, endocrine treatment) of 39 cases,and discuss the surgery treatment.Results:39 patients were 36 cases in the visit, and 3 patients were lost. 3 cases who underwent breast-conserving surgery were all in the visit. Followed up between 3 months and 6 years and 11 months, all the patients in the visit were still alive. None of them were recurrence and metastasis by examinted with breast ultrasonography, MRI, whole body bone scan and tumor markers, breast-conserving surgery and radical mastectomy in breast cancer patients without difference between simplified. Patients survived over 5 years was 7 cases, and survived more than 3 years was 15 cases. patients with postoperative upper limb edema was 6 cases.Conclusion:The treatment of DCIS should be done by breast-conserving surgery and without lymph nodes resection, and postoperative radiotherapy. For patients with multiple lesions should be done simple mastectomy surgery. The endocrine therapy should be based on ER and PR expression and clinical parameters, which are benefit for the patients with postmenopausal and ER and PR-positive and the premenopausal patients. DCIS with local invasion should as invasive carcinoma, chemotherapy should be necessary. Preoperative examination revealed axillary lymph nodes should selecte surgery frozen biopsy with the lymph nodes which are representative, axillary lymph nodes dissection may also be considered.