青年乳腺癌50例保乳治疗分析

Analysis of 50 young patients of breast cancer after conserving surgery

目的探讨35岁以下乳腺癌保乳治疗临床特点及预后。方法对50例≤35岁的乳腺癌患者的临床病例资料进行分析。全部患者均行保乳术,即局部切除或者象限切除加腋窝淋巴结清扫术。结果 50例中位随访时间11月,30岁以下患者占40.0%;肿瘤最大径:≤2 cm占48.0%,>2 cm占52.0%;淋巴结无转移占80.0%,转移者占20.0%;ER/PR(+)占70.0%,ER、PR均为阴性占30%,两组10年无瘤生存率分别为94.3%和80.0%,差异有统计学意义(P=0.041);本组患者5年累计生存率为92.0%,10年累计生存率为86.0%。结论青年乳腺癌患者保乳术后常规需要化疗、放疗,ER、PR阳性患者需要内分泌治疗。ER/PR(+)患者较ER、PR(-)患者预后好。

Objective To analyze the characteristics and the prognosis of breast cancer patients aged ≤ 35 years. Methods During April 1994 and December 2005, there were 50 breast cancer patients aged ≤35 years treated with conserving surgery in the Hospital of Tianjin Medical University. All of these patients underwent breast conserving surgery with axillaries dissection. Results The median follow-up was 11 months for 50 patients. The percentage of patients aged ≤30 years was 40.0% ;the percentage of tumor size ≤ 2 em was 48.0%, and 〉 2 cm 52.0% ; the percentage of the non-lymph node-metastasis was 80.0%, and the lymph node metastasis 20.0% ; the percentage of ER/PR（ ＋ ） was 70.0%, and both of ER and PR （ - ） 30.0%. The 10-year DFS （ disease free survival ） rates of E R/PR （ ＋ ） and ER and PR （ - ） were 94.3 % and 80.0% （ P = 0.041 ） ;the 5-year and 10-year OS （ overall survival） rates of the patients were 92. 0% and 86. 0%. Conclusions For young breast cancer patients treated with conserving surgery, the chemotherapy and radiotherapy are necessary;for ER/PR（ ＋ ） patients,endocrine therapy is necessary. The prognosis of ER/PR（ ＋ ）is better than ER and PR（ - ） patients.