Evaluation of Surgical and Systemic Treatment Results in Patients with Ductal Carcinoma In Situ

Öz

Objective: The aim of this study was to evaluate the surgical method and systemic treatment results, recurrence, and mortality rates in patients whose histopathological results were ductal carcinoma in situ (DCIS) following breast surgery in our general surgery clinic. Methods: A retrospective review was made of the preoperative and postoperative histopathological results of all patients who underwent breast surgery in our general surgery clinic between January 2016 and January 2021. The demographic data, clinicopathological features, postoperative systemic treatments, local recurrence (LR) rate, and overall survival (OS) rate of patients whose histopathological results were reported as DCIS were obtained from the data system of our hospital and the national death reporting system. Results: The study group consisted of 24 female patients with a histopathology result of DCIS. The average age of the patients was 49.96 ± 10.61 years. In the localization of the lesions in the breast, 11 (45.8%) were observed as unifocal, 7 (29.2%) as multifocal, and 6 (25%) as multicentric. The most common type of operation was lumpectomy (n = 16, 66.7%). Sentinel lymph node biopsy was performed in 8 patients. The mean follow-up period of the patients after surgery was 32.20 ± 18.22 months. Anti-estrogen hormone therapy (HT) was applied to 21 (87.5%) patients and radiotherapy (RT) to 14 (58.3%) after the operation. There was no recurrence in any of the patients and no mortality was observed. Conclusion: With a multidisciplinary approach and good preoperative staging, as applied in our general surgery clinic, it can be recommended that the most appropriate surgical method is applied, and risk factors determined for DCIS patients. RT is recommended for eligible patients after BCS and HT in estrogen receptor+ patients.

Anahtar Kelimeler

• Ductal carcinoma in situ
• lumpectomy
• mastectomy
• sentinel biopsy
• radiotherapy
• hormone therapy

Duktal Karsinoma In Situ Tanılı Hastalarda Cerrahi ve Sistemik Tedavi Sonuçlarının Değerlendirilmesi

Öz

Amaç: Bu çalışmada genel cerrahi kliniğimizde meme cerrahisi yapılan hastalarda histopatolojik sonucu duktal karsinoma in situ (DKİS) gelen hastalarımızın cerrahi yöntem ve sistemik tedavi sonuçlarını, rekürens ve mortalite oranlarını değerlendirmeyi amaçladık . Yöntem: Ocak 2016 ile Ocak 2021 tarihleri arasında, genel cerrahi kliniğiniğimizde meme cerrahisi geçiren tüm hastaların preoperatif ve postoperatif histopatolojik sonuçları incelendi. Histopatolojik sonucu DKİS gelen hastaların demografik verileri, klinikopatolojik özellikleri, reoperasyon sayısı, postoperatif radyoterapi (RT), anti-östrojen hormon tedavisi (HT), lokal rekürens (LR) oranı, ve genel sağkalım (GS) oranı hastanemiz veri datasından ve ulusal ölüm bildirim sisteminden retrospektif olarak incelendi. Bulgular: Çalışma grubu histopaptolojk sonucu DKİS gelen toplam 24 kadın hastadan oluşmakta idi. Grubun ortalama yaşı 49,96 ± 10,61’dir. Lezyonların meme içinde yerleşiminde, 11 (45,8%) ‘ i tek odaklı, 7 (%29,2) ‘si multifocal ve 6 (%25)’ sı ise multisentrik olarak gözlenmiştir. En sık uygulanan operasyon tipi lumpektomidir (n=16, 66,7%). 8 hastaya sentinel lenf nodu biyopsisi yapılmıştır. Ortanca tümör boyutu 12,5 (4-70) mm’dir. En sık görülen moleküler tip Luminal A’ dır (n=14, 58,3%). Lezyona en yakın cerrahi sınır uzaklığı ortanca 5 (0-20) mm’dir. Hastaların cerrahi sonrası ortalama takip süresi 32,20 ± 18,22 aydır. Hastaların 87,5%’si (n=21) operasyon sonrası HT ve 58,3%’ü (n=14) RT almıştır. Hastaların hiçbirinde nüks gelişmemiştir ve mortalite gözlenmedi. Sonuç: Genel cerrahi kliniğimiz olarak multidisipliner yaklaşım ve iyi bir preoperatif evreleme ile DKİS hastalarına en uygun cerrahi yöntemi ve risk faktörlerini de değerlendirerek uygun hastalarda meme koruyucu cerrahi sonrası RT ve Östrojen reseptörü+ hastalarda HT ‘ yi öneriyoruz.

Anahtar Kelimeler

• Duktal karsinoma in situ
• lumpektomi
• mastektomi
• sentinel biyopsi
• radyoterapi
• hormon tedavisi

Kaynakça

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