• 四川大學(xué)華西醫(yī)院甲狀腺乳腺外科（成都，610041）;

【摘要】　 乳腺導(dǎo)管內(nèi)癌（ductal carcinoma in situ，DCIS）為Gillis在1960年首先描述，近年隨著對(duì)DCIS認(rèn)識(shí)逐步深入和影像學(xué)篩選的廣泛應(yīng)用，其檢出率明顯增加，國外報(bào)道約占全部乳腺癌的15%~20%，我國達(dá)到7.8%~18.8%。2003年世界衛(wèi)生組織正式將DCIS（包括DCIS2MI）歸入癌前病變范疇，稱為導(dǎo)管上皮內(nèi)瘤變，認(rèn)為只有浸潤性癌才是真正的乳腺癌。對(duì)于導(dǎo)管內(nèi)癌的治療，意見還不統(tǒng)一，現(xiàn)就此進(jìn)行綜述，探討其診斷與治療方法。

引用本文： 龍泉伊,李宏江. 乳腺導(dǎo)管內(nèi)癌的診斷與治療. 華西醫(yī)學(xué), 2011, 26(7): 1000-1002. doi: 復(fù)制

1. 　Burstein JH, Polyak K, Wong JS, et al. Ductal carcinoma in situ of the breast[J]. N Engl JMed, 2004, 350(14): 1411-1430.
2. 　Adamovich TL, Simmons RM. Ductal carcinoma in situ with microinvastion[J]. Am J Surg, 2003, 186(2): 112-116.
3. 　董洋, 黃宇輝, 姚國燕, 等. 鉬靶攝片診斷乳腺導(dǎo)管內(nèi)癌價(jià)值的初步探討[J]. 罕少疾病雜志, 2009, 16(4): 16-19.
4. 　Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010[J]. CA Cancer J Clin, 2005, 60(5): 277-300.
5. 　Tabar L, Cad A, Parsons WC, et al. Mammographicap pearances of insitu carcinomas[M]//Silverstein MJ. Ductal carcinoma insitu of the breast baltimore. Baltimore: Williams & Willking, 1997: 95.
6. 　Greene T, Cocilovo C, Estabrook A, et al. A single institution review of new breast malignancies identified solely by sonography[J]. J Am Coll Surg, 2006, 203(6): 894-898.
7. 　Saslow D, Boetes C, Burke W, et al. American cancer society guidelines for breast screening with MRI as an adjunct to mammography[J]. CA Cancer J Clin, 2007, 57(2): 75-89.
8. 　Leris C, Mokbel K. The role of mammary ductoscopy in the assessment of breast disease[J]. Int J Fertil Womens Med, 2004, 49(5): 200-202.
9. 　沈鎮(zhèn)宙, 邵志敏. 乳腺腫瘤學(xué)[M]. 上海: 上海科學(xué)技術(shù)出版社, 2005: 350.
10. 　Cornfield DB, Palazzo JP, Schwartz GF, et al. The prognostic significance of multiple morphologic features and biologic markers in ductal carcinoma in situ of the breast:a study of a large cohort of patients treated with surgery alone[J]. Cancer, 2004, 100(11): 2317-2327.
11. 　Amichetti M, Caffo O, Richetti A, et al. Ten-year results of treatment of ductal carcinoma in situ(DCIS)of the breast with conservative surgery and radiotherapy[J]. Eur J Cancer, 1997, 33(10): 1559-1565.
12. 　Bordeleau L, Rakovitch E, Naimark DM, et al. A comparison of four treatments trategies for ductal carcinoma in situ using decision analysis[J]. Cancer, 2001, 92(1): 23-29.
13. 　路紅, 付麗. 乳腺導(dǎo)管內(nèi)癌的影像學(xué)與病理學(xué)對(duì)照研究進(jìn)展[J/CD]. 中華乳腺病雜志(電子版), 2010, 04(6): 631-637.
14. 　Lagios MD. Ductal carcinoma in situ:pathology and treatment[J]. Surg Clin North Am, 1990, 70(4): 853.
15. 　Gump FE, Jicha DL, Ozello L. Ductal carcinoma in situ(DCIS): a revised concept[J]. Surgery, 1987, 102(5): 790-795.
16. 　Silverstein PM. Prognostic classification of breast ductal carcinoma-iu-situ[J]. Lancet, 1995, 345(8958): 1154-1157.
17. 　姜越, 馬文鋒, 李翔. 乳腺導(dǎo)管內(nèi)癌: 附123例(125側(cè))報(bào)告[J]. 中國普通外科雜志, 2009, 18(5): 431-434.
18. 　方志沂, 于泳. 乳腺導(dǎo)管內(nèi)癌的診治研究進(jìn)展[J]. 中國腫瘤, 2007, 16(10): 769-775.
19. 　Silverstein MJ. The University of Southern California/Van Nuys prognostic index for ductal carcinoma in situ of the breast[J]. Am J Surg, 2003, 186(4): 337-343.
20. 　周雷, 王巖, 宋新, 等. 乳腺導(dǎo)管內(nèi)癌的臨床病理特點(diǎn)與治療[J]. 中華醫(yī)學(xué)雜志, 2005, 85(43): 3035-3038.
21. 　牛昀. 乳腺導(dǎo)管內(nèi)癌的基礎(chǔ)與臨床研究:一個(gè)應(yīng)倍加重視的領(lǐng)域[J/CD]. 中華乳腺病雜志(電子版), 2008, 2(6): 626-633.
22. 　Padmore RF, Fowble B, Hoffman J, et al. Microinvasive breast carcinoma: clinicopathologic analysis of a single institution experience[J]. Cancer, 2000, 88(6): 1403-1409.
23. 　Silver SA, Tavassoli FA. Mammary ductal carcinoma in situ with microinvasion[J]. Cancer, 1998, 82(12): 2382-2390.
24. 　于泳, 方志沂, 劉君. 123 例乳腺導(dǎo)管內(nèi)癌臨床特點(diǎn)和遠(yuǎn)期療效[J]. 天津醫(yī)科大學(xué)學(xué)報(bào), 2003, 9(2): 180-182.
25. 　楊璇. 乳腺導(dǎo)管癌早期浸潤15例的診治分析[J]. 中國藥物與臨床, 2008, 8(5): 417-419.
26. 　Maffuz A, Barroso-bravo S, Nájera I, et al. Tumor size as predictor of microinvasion,invasion,and axillary metastasis in ductal carcinoma in situ[J]. J Exp Clin Cancer Res, 2006, 25(2): 223-227.
27. 　Viani GA, Stefano EJ, Afonso SL, et al. Breast-conserving surgery with or without radiotherapy in women with ductal carcinoma in situ:a meta-analysis of randomized trials[J]. Radiat Oncol, 2007, 2: 28.
28. 　劉紅光, 齊海智, 康穎. 乳腺導(dǎo)管原位癌的保乳手術(shù)療效分析[J]. 中國普通外科雜志, 2007, 16(11): 1085-1087.
  1. 1. 　Burstein JH, Polyak K, Wong JS, et al. Ductal carcinoma in situ of the breast[J]. N Engl JMed, 2004, 350(14): 1411-1430.
  2. 2. 　Adamovich TL, Simmons RM. Ductal carcinoma in situ with microinvastion[J]. Am J Surg, 2003, 186(2): 112-116.
  3. 3. 　董洋, 黃宇輝, 姚國燕, 等. 鉬靶攝片診斷乳腺導(dǎo)管內(nèi)癌價(jià)值的初步探討[J]. 罕少疾病雜志, 2009, 16(4): 16-19.
  4. 4. 　Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010[J]. CA Cancer J Clin, 2005, 60(5): 277-300.
  5. 5. 　Tabar L, Cad A, Parsons WC, et al. Mammographicap pearances of insitu carcinomas[M]//Silverstein MJ. Ductal carcinoma insitu of the breast baltimore. Baltimore: Williams & Willking, 1997: 95.
  6. 6. 　Greene T, Cocilovo C, Estabrook A, et al. A single institution review of new breast malignancies identified solely by sonography[J]. J Am Coll Surg, 2006, 203(6): 894-898.
  7. 7. 　Saslow D, Boetes C, Burke W, et al. American cancer society guidelines for breast screening with MRI as an adjunct to mammography[J]. CA Cancer J Clin, 2007, 57(2): 75-89.
  8. 8. 　Leris C, Mokbel K. The role of mammary ductoscopy in the assessment of breast disease[J]. Int J Fertil Womens Med, 2004, 49(5): 200-202.
  9. 9. 　沈鎮(zhèn)宙, 邵志敏. 乳腺腫瘤學(xué)[M]. 上海: 上?？茖W(xué)技術(shù)出版社, 2005: 350.
  10. 10. 　Cornfield DB, Palazzo JP, Schwartz GF, et al. The prognostic significance of multiple morphologic features and biologic markers in ductal carcinoma in situ of the breast:a study of a large cohort of patients treated with surgery alone[J]. Cancer, 2004, 100(11): 2317-2327.
  11. 11. 　Amichetti M, Caffo O, Richetti A, et al. Ten-year results of treatment of ductal carcinoma in situ(DCIS)of the breast with conservative surgery and radiotherapy[J]. Eur J Cancer, 1997, 33(10): 1559-1565.
  12. 12. 　Bordeleau L, Rakovitch E, Naimark DM, et al. A comparison of four treatments trategies for ductal carcinoma in situ using decision analysis[J]. Cancer, 2001, 92(1): 23-29.
  13. 13. 　路紅, 付麗. 乳腺導(dǎo)管內(nèi)癌的影像學(xué)與病理學(xué)對(duì)照研究進(jìn)展[J/CD]. 中華乳腺病雜志(電子版), 2010, 04(6): 631-637.
  14. 14. 　Lagios MD. Ductal carcinoma in situ:pathology and treatment[J]. Surg Clin North Am, 1990, 70(4): 853.
  15. 15. 　Gump FE, Jicha DL, Ozello L. Ductal carcinoma in situ(DCIS): a revised concept[J]. Surgery, 1987, 102(5): 790-795.
  16. 16. 　Silverstein PM. Prognostic classification of breast ductal carcinoma-iu-situ[J]. Lancet, 1995, 345(8958): 1154-1157.
  17. 17. 　姜越, 馬文鋒, 李翔. 乳腺導(dǎo)管內(nèi)癌: 附123例(125側(cè))報(bào)告[J]. 中國普通外科雜志, 2009, 18(5): 431-434.
  18. 18. 　方志沂, 于泳. 乳腺導(dǎo)管內(nèi)癌的診治研究進(jìn)展[J]. 中國腫瘤, 2007, 16(10): 769-775.
  19. 19. 　Silverstein MJ. The University of Southern California/Van Nuys prognostic index for ductal carcinoma in situ of the breast[J]. Am J Surg, 2003, 186(4): 337-343.
  20. 20. 　周雷, 王巖, 宋新, 等. 乳腺導(dǎo)管內(nèi)癌的臨床病理特點(diǎn)與治療[J]. 中華醫(yī)學(xué)雜志, 2005, 85(43): 3035-3038.
  21. 21. 　牛昀. 乳腺導(dǎo)管內(nèi)癌的基礎(chǔ)與臨床研究:一個(gè)應(yīng)倍加重視的領(lǐng)域[J/CD]. 中華乳腺病雜志(電子版), 2008, 2(6): 626-633.
  22. 22. 　Padmore RF, Fowble B, Hoffman J, et al. Microinvasive breast carcinoma: clinicopathologic analysis of a single institution experience[J]. Cancer, 2000, 88(6): 1403-1409.
  23. 23. 　Silver SA, Tavassoli FA. Mammary ductal carcinoma in situ with microinvasion[J]. Cancer, 1998, 82(12): 2382-2390.
  24. 24. 　于泳, 方志沂, 劉君. 123 例乳腺導(dǎo)管內(nèi)癌臨床特點(diǎn)和遠(yuǎn)期療效[J]. 天津醫(yī)科大學(xué)學(xué)報(bào), 2003, 9(2): 180-182.
  25. 25. 　楊璇. 乳腺導(dǎo)管癌早期浸潤15例的診治分析[J]. 中國藥物與臨床, 2008, 8(5): 417-419.
  26. 26. 　Maffuz A, Barroso-bravo S, Nájera I, et al. Tumor size as predictor of microinvasion,invasion,and axillary metastasis in ductal carcinoma in situ[J]. J Exp Clin Cancer Res, 2006, 25(2): 223-227.
  27. 27. 　Viani GA, Stefano EJ, Afonso SL, et al. Breast-conserving surgery with or without radiotherapy in women with ductal carcinoma in situ:a meta-analysis of randomized trials[J]. Radiat Oncol, 2007, 2: 28.
  28. 28. 　劉紅光, 齊海智, 康穎. 乳腺導(dǎo)管原位癌的保乳手術(shù)療效分析[J]. 中國普通外科雜志, 2007, 16(11): 1085-1087.