保乳手术结合放 化疗在早期乳腺癌治疗中的应用

目的 评估保乳手术结合放、化疗综合治疗早期乳腺癌的疗效。方法 对2000年3月至2003年3月手术治疗乳腺癌41例患者进行回顾性研究,41例均行包括原发灶肿块在内的象限切除,35例加行腋窝淋巴结清扫。手术后均行放、化疗,放疗前化疗1个周期,完成放疗之后再化疗（CMF或CEF方案）5个周期。ER、PR阳性者,加用内分泌治疗。结果 病理检查Ⅰ期19例、Ⅱ期22例。随访6-56个月。1例出现上肢水肿,有2例局部复发,行补救性改良根治术,分别随访23个月及86个月至今,无远处转移及死亡。2例出现乳房的纤维化、局部疼痛。美容效果满意率为92%。结论选择部分Ⅰ-Ⅱ期乳腺癌患者行保乳手术治疗,乳房外形及临床疗效满意,而且可以提高生活质量。

Objective To give a Clinical evaluation of breast conservation operation combirdng with radiochemotherapy in treating early breast cancer . Methods A retrospective review was made to the 41 patients of breast cancer who had operation from March ,2000 to Match ,2003. All the 41 patients had quadrant resection including the primary lesion , 35 patients also had the axillary nodes dissection. They all had radiochemotherapy postoperatively , one cycle of chemotherapy before radiotherapy and 5 cycles afterwards （CMF or CEF protocol）. Endocrine therapy was added in case of ER（ ＋ ） and PR（ ＋ ）. Results Pathological diagnosis showed 19 cases of stage Ⅰ and 22 of stage Ⅱ The follow - up was 6 - 56 months . Edema of the upper extremity occurred in one case , local reoccurrence happened in two cases , salvage radical surgery was apphed , with follow - up of 23 and 86 monther respectively till now , no distant metastasis or death were found . Fibrous degeneration and localized pain occurred in two cases . Satisfactory rate of cosmetic result was 92%. Conchtsions By breast conservation operation in part of the patients with breast cancer of Ⅰ-Ⅱ stage, not only the breast shape and clinical therapeutic effect but an improvement in life quality could be achieved .