根據(jù)2004年11月22日《癌癥》在線期刊上發(fā)表的研究結(jié)果：女性遺傳性乳腺癌患者接受保留乳房的乳腺癌切除術(shù)，手術(shù)過(guò)的乳房癌癥復(fù)發(fā)的風(fēng)險(xiǎn)不會(huì)增加。

保留乳房的乳腺癌切除術(shù)(Breast-conserving therapy, BCT)，包括乳房局部病灶切除術(shù)和放療，用于治療非遺傳性或者散發(fā)性早期乳腺癌已經(jīng)被證明是安全有效的。但是使用BCT治療BRCA1和BRCA2基因突變的女性乳腺癌患者則仍然存在爭(zhēng)議。這是因?yàn)橛匈Y料認(rèn)為手術(shù)過(guò)的乳房癌癥復(fù)發(fā)的風(fēng)險(xiǎn)增加，未治療的乳房會(huì)生成新的腫瘤，這些資料充滿矛盾。在一項(xiàng)新研究中，對(duì)87例診斷為乳腺癌而且有BRCA突變的女性使用BCT治療后遠(yuǎn)期的癌癥風(fēng)險(xiǎn)進(jìn)行了評(píng)估。

研究者發(fā)現(xiàn)：與年輕無(wú)基因突變的女性乳腺癌患者相比，手術(shù)過(guò)的乳房癌癥復(fù)發(fā)風(fēng)險(xiǎn)并沒(méi)有增加。在明確診斷后的10年，13.6％有基因突變的女性出現(xiàn)腫瘤復(fù)發(fā)，與以前使用BCT治療的非遺傳性乳腺癌女性相似。但是超過(guò)半數(shù)的女性患者在診斷后的10年內(nèi)發(fā)生腫瘤相關(guān)性事件，37.6％的患者未手術(shù)治療的乳房生成新的癌癥。

“保留乳房的乳腺癌切除術(shù)對(duì)BRCA突變女性患者是一種合理的治療選擇，單側(cè)乳房切除術(shù)的手術(shù)指征對(duì)遺傳性和非遺傳性乳腺癌患者是相同的，”作者總結(jié)說(shuō)。但是，作者提醒“應(yīng)當(dāng)對(duì)雙側(cè)乳房切除術(shù)進(jìn)行論證，以確保控制對(duì)側(cè)乳房發(fā)生癌癥的風(fēng)險(xiǎn)。”該項(xiàng)研究由Mark Robson醫(yī)學(xué)博士和Memorial Solan-Kettering癌癥中心(New York, NY, USA)的同事完成的。

Breast-Conserving Therapy for Hereditary Disease
 
Women with hereditary breast cancer treated with breast-conserving therapy have no increased risk for recurrence in the treated breast, according to a study published in the November 22, 2004, online issue of Cancer.

Breast-conserving therapy (BCT), consisting of lumpectomy and radiation, has been demonstrated in the past to be a safe, effective treatment for nonhereditary or sporadic forms of early breast cancer. However, the use of BCT for women with mutations in BRCA1 and BRCA2 genes has been controversial because of conflicting data about the increased risk of recurrence in the treated breast and the development of tumors in the untreated breast. In the new study, 87 women diagnosed with breast cancer and BRCA mutations were treated with BCT to evaluate their long-term cancer risks.

Investigators found no increase in the risk of cancer recurrence in the treated breast, compared to young women without mutations. Ten years after diagnosis, 13.6% of the women with a genetic mutation had experienced a recurrence similar to previously found rates for women with nonhereditary cancers treated with BCT. However, more than half of the women suffered a cancer-related event within 10 years of their diagnosis, including 37.6% who experienced a new cancer in the untreated breast.

“Breast-conserving treatment is a reasonable option for [women with BRCA mutations], and the indications for unilateral mastectomy should be the same for both hereditary and nonhereditary breast cancer,” concluded the authors. However, they caution that “discussion of bilateral mastectomy is warranted by the significant contralateral breast cancer risk.” The study was conducted by Mark Robson, M.D., and colleagues from Memorial Sloan-Kettering Cancer Center (New York, NY, USA).