乳腺癌术后胸壁复发临床分析

The clinical analysis of chest wall recurrence of breast cancer after mastectomy

目的探讨乳腺癌术后胸壁局部复发的相关因素，寻找预防和降低乳腺癌术后胸壁复发的有效措施。方法回顾性分析乳腺癌术后局部复发而无远处转移的67例患者的临床资料。结果本组患者占同期全部乳腺癌病例的7．6％，其中42例（62．7％）在手术后2年内复发。T1～T4复发率分别为0．9％、3．8％、12．7％和34．6％，腋窝淋巴结（-）与腋窝淋巴结（＋）患者的胸壁复发率分别为1．7％、7．8％，腋窝淋巴结转移≥4个者复发率高达t3％。结论腋窝淋巴结转移数目多、原发灶分期晚者易出现胸壁复发。对乳腺癌术后易复发的高危人群应规范化治疗，术后放疗是预防胸壁复发的有效措施。

Objective This paper explores the reason for chest wall recurrence of breast cancer after mastectomy, hoping to find an efficient way to prevent and reduce chest wall recurrence after mastectomy. Methods For 67 patients with local recurrence on the chest wall after mastectomy clinical data was reviewed retrospectively. Results This group of paticnts was 7.6% of all breast cancer paticnts in the same period Most of recurrences （62. 7% ）occured within two years affcr operation. The recurrent rate of T1-T4 was 0. 9%, 3.8 %, 12.7% and 34. 6% respectively. Rate of chest wall recurrence in patients with negative axillary nodes and positive axillary nodes was 1.7% ,7.8% ,but if the amount of positive axillary nodes≥4 ,it was 13%. Conclusion In the patients who had more positive axillary nodes, larger primary tumor, recurrence on the chest wall was seen more often. Postoperative radiotherapy arc efficient ways to prevent recurrence on the chest wall.