[fr] Dans le cadre de la prise en charge multidisciplinaire
du carcinome intracanalaire du sein (carcinome intra-canalaire
in situ = DCIS = Ductal Carcinoma In Situ), on évoque souvent la possibilité de renoncer à la radiothérapie complémentaire
après un geste de chirurgie conservatrice. S’il est vrai que la radiothérapie, dans ce contexte, n’apporte pas de bénéfice en survie, il n’en reste pas moins qu’on observe à long terme un effet bénéfique en contrôle local. Il existe un effet significativement marqué sur le taux de rechute de type DCIS et de type invasif dans les différentes études randomisées destinées
à éclaircir la problématique du rôle de la radiothérapie. La question est de savoir si on peut distinguer un sous-groupe de patientes pour qui le contrôle local n’est pas modifié par l’adjonction d’une radiothérapie adjuvante. Pour l’instant, nous ne sommes pas à même de définir ce sous-groupe, car les critères de sélection n’ont pas été mis à l’épreuve dans le cadre d’un essai randomisé. Faute de ces données, il nous semble
plus adéquat de proposer jusqu’à preuve du contraire, une radiothérapie aux patientes opérées, même si l’intervention est a priori radicale, mais conservatrice, et même si les facteurs pronostiques semblent plutôt favorables. Cependant, la radiothérapie
n’est pas indiquée après une mastectomie.
Disciplines :
Hematology Oncology
Author, co-author :
Coucke, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie
Barthelemy, Nicole ; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie
Other collaborator :
Jansen, Nicolas ; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie
Triviere, Nicolas ; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie
Jerusalem, Guy ; Centre Hospitalier Universitaire de Liège - CHU > Oncologie médicale
Language :
French
Title :
Carcinome intracanalaire (in situ) du sein : pouvons-nous raisonnablement éviter les radiothérapie pour certaines patientes opérées?
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