I carcinomi in situ della mammella: inquadramento clinico ed attualità terapeutiche

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COD: 003-012 Categorie: ,

Federico Attene, Fabrizio Scognamillo, Emilio Trignano, Giovanni Battista Meloni, Corrado Rubino, Mario Trignano

Ann. Ital. Chir., 2006; 77: 3-12

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INTRODUCTION: Lobular and ductal carcinomas in situ of the breast (LCIS and DCIS) origin from the ductal-lobular
unit of mammary gland, but they are characterized for different morphologic patterns and evolution. In 1980 they represent
1.4% of diagnosis in breast biopsy, less of 5% of carcinomas of the breast. Actually in 7.5% of breast biopsy an
in situ carcinoma is recognized (approximating 40% of breast cancers). Our purpose is to evaluate the different available
strategies in the clinic management of DCIS and LCIS and, in case of surgical treatment, which reconstructive
approach obtains satisfactory breast conformation.
MATERIALS AND METHODS: The study enclose 125 patients: 40 of them presented LCIS (32%) and 85 DCIS (68%).
In 40 patients (32%) underposed to mastectomy was performed a reconstruction in cooperation with aesthetic surgeons.
35 of 40 women with LCIS are included in a follow-up programme, 5 of them had a bilateral mastectomy and reconstruction.
RESULTS: No recurrences were observed in patients affected by LCIS. Six patients underposed to wide excision for DCIS
developed local recurrence, treated by mastectomy. No recurrences were observed in patients treated initially with mastectomy.
Some complications correlated to reconstruction were detected.
CONCLUSIONS: One of most controversial sights in breast pathology is the understanding of biological meaning of CLIS:
in facts CDIS can be considered a pre-invasive cancer, CLIS is reasonably considerable only a risk indicator for developing
breast cancer but it isn’t a pre-neoplastic lesion. Very important is the reconstruction of the breast to improve the
quality life of patients.

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