乳腺癌保乳综合治疗(附108例分析)

The analysis of conservative operation for the breast cancer(analysis of 108 cases)

背景与目的：保乳手术已逐步成为早期乳腺癌手术治疗的重要方法之一,本文探讨乳腺癌保乳综合治疗的原则与临床应用疗效。方法：108例乳腺癌,0期（TisN0M0）5例,Ⅰ期（T1N0M0）58例,ⅡA期36例（T2N0M017例,T0-1N1M019例）,ⅡB期（T2N1M0）9例,局部保乳切除＋腋窝淋巴结清扫,术后辅以化疗、放疗、内分泌等综合治疗,随访24-144个月,平均随访78月。结果：随访3年以上者80例,5年以上者65例;5年局部复发率3.75%,局部总复发率6.25%;3年生存率96.3%,5年生存率为92.3%;外形满意率81.5%。结论：掌握保乳的手术指征,保证术后的综合治疗,能够使早期乳腺癌患者接受保乳综合治疗取得满意的疗效。

Background and purpose： Breast-conserving therapy has been one of the important operation therapies for breast cancer in early stage. This article discussed the treatment principle and clinical appliance of conservative operation for breast cancer. Methods： 108 patients with breast carcinoma （ 0 stage with 5 cases, Ⅰ stage with 58 cases , Ⅱ A stage with 36 cases, ⅡB stage with 9 cases） who underwent tumourectomy or quadranteetomy and axillary nodes dissection and postoperative radiotherapy, chemotherapy , endocrinotherapy and targeted therapy were followed up ranging from 24 to 144 months and observed for the clinical curative effect. Results： In 108 cases, 80 were followed up over 3 years and 65 cases over 5 years. The 5-year local recurrent rate was 3.75%, and the total local recurrent rate was 6.25%. The 3-year survival rate was 96.3% , The 5-year survival rate was 92.3%. The satisfaction rate was 81.5%. Conclusions： If the surgical indication and the necessary safe margin in resection of conservative surgery is obeyed by and followed in combined therapy, conservative surgery is satisfactory in the treatment of early breast cancer.