T_2N_0M_0乳腺癌治疗方法的选择

TREATMENT OF T 2N 0M 0 BREAST CANCER

探讨Ｔ２Ｎ０Ｍ０乳腺癌治疗方法的选择。方法回顾分析７０２例Ｔ２Ｎ０Ｍ０乳腺癌的淋巴结转移情况、手术方式和辅助治疗的效果。结果Ｔ２Ｎ０Ｍ０乳腺癌临床检查淋巴结假阴性率为３５．２％。各种手术方式在淋巴结阴性时生存率相似。辅助放疗可降低局部复发，辅助化疗在淋巴结转移超过４只者可提高生存率。结论Ｔ２Ｎ０Ｍ０乳腺癌病灶≤３ｃｍ可作改良根治术，病灶＞３ｃｍ且位于中央或内侧应同时清除内乳淋巴结。术后应根据不同情况选择不同的辅助治疗。

PURPOSE To study the treatment of T 2N 0M 0 breast caner. METHODS 709 cases of T 2N 0M 0 breast cancer who were operated in our hospital from 1956 to 1993 were studied. RESULTS 35.2% of T 2N 0M 0 patients bad histologically positive axillary nodes. The survival rates for all modes of surgery were similar when the nodes were negative. Adjuvant radiotherapy decreases local recurrence rate, while adjuvant chemotherapy for patients with more than 4 positive nodes can improve survival rates. CONCLUSIONS We believe that the axillary lymph nodes should be dissected in T 2N 0M 0 patients. T 2N 0M 0 patients with lesions less than 3 cm in diameter were suitable for modified radical mastectomy. Internal mammary lymph nodes should be dissected in patients with central or inner quadrant lesions greater than 3 cm diameter. Depending on the situtation, the suitable adjuvant therapy can be give.