患有导管癌的妇女原位的边缘阈值

在哺乳手术（BCS）后，应在原位（DCIS）患者原位（DCIS）患者的阴性手术边缘，无论放射治疗，外科医生应试图根据3月22日发布的一项研究首次在化妆品克制内部尝试达到广泛负面的边距在里面国家癌症研究所杂志。

保证金状态是局部复发的重要预测因子，无论什么后续放射疗法（rt）为与BCS治疗的DCIS的妇女。同侧乳房的风险肿瘤再次发生（IBTR）在BCS为DCIS之后降低，如果周围的边距肿瘤切除没有癌细胞（负余量）。但是，外科医生在最低的最小负边距宽度方面没有统一的协议。

In order to determine the association between different negative margin widths for DCIS after BCS and risk of local recurrence, Shi-Yi Wang, M.D., MS of the Division of Health Policy and Management at the University of Minnesota School of Public Health and colleagues gathered data from the PubMed database for studies of DCIS published in English between January 1970 and July 2010. The women with DCIS were classified as either having had BCS with radiotherapy or BCS without radiotherapy. Wang performed a meta-analysis to determine the association between negative margin width and the risk of IBTR in women treated with BCS with or without RT.

研究人员在24篇文章中发现了21项研究，该研究鉴定了更广泛的负数边距和IBTR的风险之间的关联，或没有放射治疗。他们还发现，无论放射治疗治疗如何，至少有10mm的负边缘与IBTR的风险较小。“RT不能依赖于减轻积极边距的负面影响，”他们写入，加入“，因为BCS受到美容约束，并非所有手术都可以保证10毫米自由边距，RT应始终被认为是最优先事项。因为边缘和治疗是可修改的因素，所以我们强调RT应补充（而不是由）较宽自由利润的目标，以最小化IBTR。“

In an accompanying editorial, Monica Morrow, M.D., of the Department of Surgery at the Memorial Sloan-Kettering Cancer Center in New York and Steven J. Katz, M.D., MPH, of the Department of Medicine and Health Management and Policy at the University of Michigan, point out the study's limitations and potential biases and question whether adoption of a 1 centimeter margin was likely to be of benefit, or to result in more mastectomies and more re-excisions with little overall improvement in the health of women with DCIS. "Only 5 of the 21 studies included in the meta-analysis reported margin widths of 1cm or more. It is just as clinically plausible to hypothesize that tumors with more favorable prognosis were more likely to result in more widely clear margins," Morrow and Katz write. They also question whether randomized clinical trials to test optimal margin widths would be worth the large financial investment, given the results of earlier studies suggesting that the benefit of better defined margins on the overall health of women would be relatively negligible.

“研究所需的患者和财政资源量化如此小的差异，如果致力于识别导致DCIS进展的因素，则可能会做得更好，以侵入癌症的知识 - 这对我们定制的能力至关重要治疗与优化个体患者的净利益。“

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