早期乳腺癌保乳手术探讨

Study of breast conservation surgery for early stage breast cancer

目的探讨早期乳腺癌保乳手术加放疗治疗效果。方法分析近6年7 6例保乳术后加放疗的乳腺癌病人临床资料。结果7 6例患者3,5年生存率分别为9 6.0 5%,9 4.8%;3,5年局部复发率分别为5.3%,6.6%;术后3,5年乳房保留率分别为9 6.0 5%,9 3.3%;仅1例胸壁复发,无死亡病例。该复发病例2 5岁,未婚,保乳愿望强烈,复发后再次行乳房切除及化疗,现健在。术后形体美容效果满意度8 0.5%。结论早期乳腺癌采用保乳手术及放射治疗可取得满意结果,规范化的切除和术后放疗、全身综合治疗是保乳治疗成功的关键。

Objective To evaluate the results of breast conservation surgery combined with radiotherapy for early stage breast cancer. Methods The cinical data of 76 breast cancer patients who underwent breast conservation operation plus radiotherapy at Changzheng Hospital in the recent 6 years were retrospectively analyzed. Results The 3 - , and 5 - year survival rate was 96.05 % and 94.8 % , respectively, the 3 - , and 5 - year local recurrence rate was 5.3 % and 6.6 % respectively, and the 3 - , and 5 - year breast conservation rate was 96.05 % and 93.3 % , respectively. Only one case had chest wall recurrence and there was no mortality. The case with recurrence was a 25-year old unmarried woman, who had an intense desire for breast conservation. After tumor recurrence, mastectomy was performed again and chemotherapy was administered. The patient is presently alive and in good health. Postoperative cosmetic physical results were satisfactory in 80. 5 % of cases. Conclusions Breast conservation surgery plus radiotherapy can get satisfactory results. The important aspects for success of breast conservation treatment are standardization of resection and postoperative radiotherapy and integrated systemic therapy.