较大乳腺癌新辅助化疗后保乳手术24例报告

Breast Conservative Surgery for Large Breast Carcinoma after Neoadjuvant Chemotherapy:Report of 24 Cases

目的探讨较大乳腺癌新辅助化疗后保乳手术的可行性。方法2003年6月～2006年9月我院对24例肿瘤直径>3cm的乳腺癌行空心针穿刺活检,以紫杉醇和(或)表阿霉素为主的联合新辅助化疗2～4个周期,化疗后7～10d行保乳手术。结果24例接受2～4个周期的新辅助化疗,临床完全缓解率(CR)12.5%(3/24),部分缓解率(PR)87.5%(21/24),病理完全缓解率(pCR)8.3%(2/24)。14例成功完成保留乳房手术,保留乳房率58.3%(14/24),7例不符合保留乳房规范直接行改良根治术,3例术中冰冻切缘阳性改行改良根治术。24例随访5～44个月,中位时间24个月,无局部复发和远处转移。结论对于较大的乳腺癌,采用新辅助化疗缩小降期后,使相当部分患者获得保乳机会。

Objective To investigate the feasibility of breast conservative surgery for large breast carcinoma （over 3 cm in diameter） after neoadjuvant chemotherapy. Methods A total of 24 patients with breast carcinoma larger than 3 cm in diameter underwent core needle biopsy and neoadjuvant chemotherapy with paelitaxel and/or epirubicin in our hospital from June 2003 to September 2006. The chemotherapy was carried out for 2 to 4 cycles, and then breast conservative surgery was performed in 7 to 10 days. Results After the neoadjuvant chemotherapy, 3 （ 12.5% ） patients achieved CR, and 21 （87.5%） had PR. Pathological CR was detected in 2 （8.3%） of the patients. The breast conservative surgery was completed in 14 cases （58.3%） , 10 patients were converted to modified radical resection. The patients was followed up for 5 to 44 months with a median of 24, during which none of them had recurrence or distant metastasis. Conclusions For patients with large breast carcinoma, breast conservative surgery is feasible after neoadjuvant chemotherapy.