炎性乳腺癌综合治疗的探讨

Comprehensive Therapy of Inflammatory Breast Cancer

目的:探讨炎性乳腺癌的临床特点、治疗经验及预后因素.方法:对我院1987～2002年收治的48例炎性乳腺癌的临床资料进行回顾性分析,按TNM分期,Ⅲb期37例,Ⅳ期11例,无特定的组织学类型,48例患者均接受综合治疗.结果:全组平均生存期34个月,2年生存率46.9%,5年生存率34.4%,Ⅲb期生存5年者11例,Ⅲb期1年内死亡者有7例,Ⅳ期中3例1年内死亡.结论:炎性乳腺癌恶性程度高,预后极差.其乳房皮肤红斑范围、术前对化疗药物的敏感性、腋窝淋巴结转移状况和局部血管受累情况以及分期等与预后有关,主张采用新辅助化疗-手术或局部放疗-辅助化疗的综合方法进行治疗.

Objective： To explore the clinical characteristics, treatment and prognostic factors of patients with inflammatory breast cancer（IBC）. Methods：Clinical data of 48 patients with IBC between 1987 -2002 were reviewed retrospectively. According to TNM staging system,there were 37 cases in stage Ⅲ b, 11 cases in stage Ⅳ. All patients received combination therapy. Results：The median survival of this group of 48 patients was 34 months. The 2-year,5-year survival rate was 46.9% and 34.4% respectively, 17 cases in stage mb survival over 5 years,7 cases in stage Ⅲb died within 1 year. 3 cases in stage Ⅳ died within l year. Conclusion：The prognosis of IBC is rather poor. The range of mammary erythema, pharmic sensitivity of IBC preoperation,the metastasis of axillary lymph nodes and pathologic stages are related to prognosis. We suggest the combine methods is better： neoadjuvant chemotherapy-operation or local radiotherapy-assistant chemotherapy.