乳腺癌保留乳房治疗的探索(30例分析及文献复习)

Conservative Surgical Treatment of Primary Breast Cancer

自1985年以来,开展了乳腺癌保留乳房治疗的探索,至1989年底共治疗30例.其中1期10例、Ⅱ期20例.采用乳腺区段切除、全腋淋巴结清扫术,术后术区加行放疗.术后化疗和/或内分泌治疗与同期乳腺癌根治术后治疗原则相同.经过3、5年观察,其复发者<3年1/7,≥3年2/13,≥5年1/4.3例复发者均为同侧乳腺内复发,经行肿瘤切除或全乳切除补救,2例分别术后3年半、2年未再复发,1例正在治疗中.探索结果,Ⅰ、Ⅱ期乳腺癌患者中,选择性保留乳房治疗的方案是可行的.

The results of conservative surgery for breast cancer in 30 patients treated at the Shandong Tumor Hospital and Research Institute between 1985 through 1989 are reported. Among them there are 10 cases of stage Ⅰ disease,20 stage Ⅱ cases. Surgery consisted of segmental mastectomy plus total axillary lymph node dissection followed by whole breast irradiation with or without regional lymph nodal irradiation. Adjuvant chemotherapy and endocrinotherapy were similar to those after Halsted radical mastectomy. The patients have been followed for 3-5 years and local recurrences were found in 1/17 at 3 years and in 2/13 at 3-5 years and 1/4 at 5 years. After re-excision or total mastectomy,two of the these cases is surviving without tumor for 3. 5 and 2 years and a third one is still under treatment. It is concluded that it is possible to perform breast-sparing treatment selectively in stage Ⅰ and Ⅱ breast cancer.