浸润性小叶癌（ILC）是乳腺癌第二常见的亚型。尽管已知乳房 X 光检查对 ILC 的敏感性较低，但没有数据可以指导治疗后的最佳监测。我们探索了针对 ILC 的保乳手术 (BCS) 后的监测策略，并确定了影像学检测到的复发与间期癌症的比例。从 813 名女性的机构数据库中，我们回顾性地识别了因 ILC 期而接受 BCS 并随后接受 BCS 的患者。又复发了。我们根据监测策略对患者进行分类，并确定复发检测的方式。使用卡方检验比较不同监测策略的局部复发的间期癌症发生率。我们使用对数秩检验和 Cox 比例风险模型评估了总体生存率。我们纳入了 58 名在 BCS 后复发的 ILC 患者。其中，22例（37.9%）有局部复发，27例（46.6%）有远处复发，9例（15.5%）有局部和远处复发。大多数患者接受了常规乳房X线摄影监测（65.2%），其中19.6%进行了补充乳腺磁共振成像（MRI），15.2%没有进行监测。与 MRI 监测组相比，乳腺 X 线摄影监测组的间期癌症发生率显着较高（61.9% vs. 16.7%；p < 0.001）。 在这项针对 I-III 期 ILC 进行 BCS 初级治疗后复发患者的研究中，我们发现大多数局部复发并未通过监测乳房X光检查发现。这些数据支持针对接受 BCS 的 ILC 患者在乳房 X 线摄影之外进行补充成像的进一步研究。© 2024。作者。

Invasive lobular carcinoma (ILC) is the second most common subtype of breast cancer. Although mammography is known to have low sensitivity for ILC, there are no data to guide the optimal surveillance after treatment. We explored surveillance strategies after breast-conserving surgery (BCS) for ILC and determined the proportion of imaging-detected recurrences versus interval cancers.From an institutional database of 813 women, we retrospectively identified patients who underwent BCS for stage I-III ILC and subsequently had a recurrence. We categorized patients by surveillance strategy and determined the modality of recurrence detection. Interval cancer rates for local recurrences were compared across surveillance strategies using the Chi-square test. We evaluated overall survival with the log-rank test and a Cox proportional hazards model.We included 58 patients with ILC who had a recurrence after BCS. Of these, 22 (37.9%) had local recurrence, 27 (46.6%) had distant recurrence, and 9 (15.5%) had both local and distant recurrence. Most patients underwent routine mammographic surveillance (65.2%), with 19.6% having supplemental breast magnetic resonance imaging (MRI) and 15.2% having no surveillance. The interval cancer rate was significantly higher in the mammographic surveillance group compared with the MRI surveillance group (61.9% vs. 16.7%; p < 0.001).In this study of patients with recurrence after BCS for primary treatment of stage I-III ILC, we found that most local recurrences were not detected by surveillance mammography. These data support further investigation of supplemental imaging beyond mammography specifically for patients with ILC who undergo BCS.© 2024. The Author(s).