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远程复发和边际参与侵袭性乳腺癌

Sarah Michael^1,2, John Broggio³, Sarah Bowers^1,2

¹University of Manchester, Manchester, UK.

British journal of cancer

|January 6, 2026

概括

乳腺癌手术后所涉及的边缘增加了远期复发和癌症死亡的风险. 达到大于1mm的边缘与更好的结果有关,这表明需要更新的指南.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
乳腺癌研究研究乳腺癌研究

背景情况:

手术边缘参与对乳腺癌患者远程复发 (DR) 的影响尚不清楚.
了解边际状况对于预测长期结果和改进外科手术策略至关重要.

研究的目的:

调查外科手术边缘宽度与与远程复发 (DR) 和乳腺癌死亡率相关的关系.
确定最佳的边缘清除,以减少乳腺癌患者的复发和改善乳腺癌患者的存活率.

主要方法:

大曼彻斯特 (GM) 和国家癌症登记 (NCRAS) 队列的分析.
利用Cox比例危险模型来评估与局部复发 (LR),DR和乳腺癌死亡相关的因素.
在接受乳腺保护手术 (BCS) 的患者中评估边缘状态 (清晰,接近,参与).

主要成果:

在BCS患者中,所涉及的边际 (<1mm) 与DR (HR 1.73) 和LR (HR 2.16) 的风险增加显著相关.
对NCRAS数据的分析显示,23.9%的BCS患者的边缘小于1mm,与边缘大于1mm (3.4%) 患者相比,死亡率更高 (5.6%).
在BCS后的涉及边际 (<1mm),特别是在接受化疗的患者中,癌症死亡的HR为1.33.

结论:

超过1mm的边缘与远程复发和癌症死亡率的减少有关.
目前的指导方针应更新,建议乳腺癌患者的最低外科边缘清除值为1mm.
获得足够的边缘清除是改善乳腺癌手术后长期存活的关键因素.

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