乳腺癌保乳手术47例分析

Treatment of breast cancer with breast-conserving therapy(report of 47 cases)

目的探讨保乳手术在乳腺癌治疗中的应用. 方法回顾性分析47例行乳腺癌保乳手术患者的临床资料.手术指征:肿瘤直径≤3.0cm的临床Ⅰ期、Ⅱ期乳腺癌;单发病灶,X线钼靶片无广泛钙化;肿瘤边缘到乳晕边缘距离≥2.0cm;肿瘤与乳房比例适度;患者有保乳意愿.手术方式为局部广泛切除加腋窝淋巴清扫.术后行辅助放疗、化疗和内分泌治疗. 结果术后病理检查提示,切缘无癌细胞浸润.经3～87个月(中位31月)随访,45例健康存活,2例因复发转移死亡,总生存率95.7%.对综合治疗满一年的34例进行乳房外形效果评定,结果:优13例,良16例,差5例,优良率85.3%. 结论保乳手术适用于治疗早期、Ⅰ期和部分肿瘤直径≤3.0cm的Ⅱ期乳腺癌,近期疗效满意.

Objective To investigate the indications and results of breast conserving therapy （BCT ）. Methods Forty-seven patients with breast carcinoma underwent BCT from January 1997 to December 2004. The indications include： （1 ） the tumor size ≤3.0cm in diameter and classification with stage Ⅰ and part of stage Ⅱ patients ; （2 ） the muhicentre cancer or the extensive calcification were excluded by preoperative mammograms ; （3 ） the distance between tumor edge and aerolar edge was≥2.0cm; （4） the ratio of tumor and breastwas appropriate; （5） the patient had the desire to preserve her breast. The manner of surgical treatment was wide excision of tumor or quadrantectomy plus axillary dissection. Adjuvant irradiation, chemotherapy and hormone therapy were given postoperatively. Results The breast specimens were examined and no infiltratingmargin was found. The median time of follow-up was 31 months （ range 3 ～ 87 months ）. 45 cases were survival （95.7% ）,2 cases were dead from recurrence or distant metastasis. The superior rate of the breast form of the patients who received BCT 12 months previously was 85.3%. Conclusion For the patients with early stage breast carcinoma and part of local advanced breast cancer（ the tumor size≤3.0cm in diameter） , the result of BCT is satisfactory.