Ⅳ期乳腺癌的外科治疗及TNM分期探讨

SURGICAL TREATMENT AND TNM STAGING INVESTIGATION ABOUT STAGE Ⅳ BREAST CARCINOMA

目的 探讨Ⅳ期乳腺癌的分期与外科治疗方法。方法 对 38例Ⅳ期乳腺癌的外科治疗资料进行总结 ,并随访疗效。结果 对孤立的远处转移而局部病灶又能够切除的Ⅳ期乳腺癌患者采用根治性外科治疗 ,取得了较好效果 ;对有锁骨上淋巴结以外的广泛远处转移的Ⅳ期患者 ,以及局部肿瘤已无法切除的晚期乳腺癌 ,行姑息性的减瘤术 ,清除创面 ,改善了患者的生存质量和减少化疗负荷。结论 Ⅳ期乳腺癌的TNM分期应进一步分为Ⅳa 期及Ⅳb 期 ;Ⅳa期乳腺癌应选择根治性手术 ,Ⅳb 期应采用姑息性手术。

Objective To study the surgical therapy and staging investigation about stage Ⅳ breast carcinoma. Methods The clinical data of 38 patients with stage Ⅳ breast carcinoma were summarized, and the patients were followed up. Results The stage Ⅳ patients who had isolated metastasis and removable primary tumor were treated by radical surgery with good effect. On the other hand, the stage Ⅳ patients who had extensive metastasis and primary tumor unresectable were treated by palliative operation with the living quality of patients becoming better and chemotherapy load cutting down. Conclusion The stage Ⅳ patients should be divided into stage Ⅳ a and stage Ⅳ b. And the stage Ⅳ a patients should be treated by radical operation, and the stage Ⅳ b by palliative operation.