A közlemény célja a magyarországi multicentrikus, randomizált DCIS vizsgálat korai eredményeinek ismertetése. 2000 és 2007 között 278 DCIS miatt emlőmegtartó műtéttel kezelt beteget randomizáltunk a lokális recidíva szempontjából meghatározott rizikócsoportok szerinti besorolás után. Alacsony/közepes kockázat esetén (n=29) a betegek 50 Gy sugárkezelésben vagy szoros obszervációban részesültek. Magas kockázat mellett (n=235) 50 Gy vagy 50 Gy + 16 Gy tumorágy “boost” besugárzást adtunk. Igen magas kockázat (pozitív sebészi szél) esetén (n=14) a betegek emelt dózisú (50 Gy + 16 Gy “boost”) sugárkezelésen vagy reoperáción (reexcízió + sugárkezelés vagy masztektómia) estek át. Immunhisztokémiai (IHK) módszerrel vizsgáltuk a lehetséges molekuláris prognosztikai markerek (ER, PR, Her2, p53, Bcl-2 és Ki-67) expresszióját. A 36 hónapos medián követési idő alatt az alacsony/közepes és igen magas rizikójú betegcsoportokban daganatkiújulást nem észleltünk. A magas rizikójú betegcsoportban 4 (1,7%) lokális recidíva és 1 (0,4%) távoli áttét alakult ki, emlődaganatos haláleset nem volt. A magas rizikójú betegcsoportban a helyi daganatkiújulás 3 és 5 éves valószínűsége 1,1% és 3,1% volt. A pozitív IHK reakció a Her2 (38%), p53 (37%) és Ki-67 (44%) markereknél a nukleáris grade-del korrelált. Ezzel szemben az ER- (77%), PR- (67%) és Bcl-2- (64%) pozitivitás szignifikáns inverz összefüggésben volt a grade-del. Korai eredményeink alapján az emlő-DCIS kezelésében az emlőmegtartó műtét és posztoperatív sugárkezelés alkalmazásával a helyi daganatkiújulás éves aránya 1% alatt marad. A molekuláris prognosztikai faktorok IHK vizsgálata segíthet a DCIS biológiai heterogenitásának feltérképezésében.
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