Ⅰ、Ⅱ期乳腺癌腋窝淋巴结的处理

Management of Axillary Lymph Node in Breast Cancer with Stage Ⅰand Ⅱ

５１８例Ⅰ、Ⅱ期乳腺癌腋窝淋巴结按处理方法分为单纯放疗组和手术腋窝淋巴结清扫加放疗组。两组５、１０、１５年生存率和局部复发率无显著性差异。局部复发（腋窝复发和锁骨上淋巴结转移）受年龄和治疗前腋窝淋巴结状态的影响，与治疗方法及乳腺肿块大小无关。单纯放疗组２例出现上臂水肿，而后者高达１８例。因而对于老年或Ｎ０患者单纯放疗能更完整保留上肢功能。

Five hundreds and eighteen patiens breast cancer(T 0 2 ,N 0 la ,M0)were treat at the center Rene Hugunin( scant cloud)between 1960 and 1980.335 patients treated axillary lymph node by radiotherapy only. Rates local relapse and survial at 5,10,15 years were respective 1 9%,3 2%,6 4% and 93%,86%,83%. For the 183 patients management by lower axillary dissection and irrdiation, rates recuence and survival at 5,10,15 years were respective 1 5%,5 8%,7 1% and 90%,80%,78%. Analysis of recurrences and survival differences of the two subtypes were not significant. Multiva riate analysis of the risk factor for local relapse showed that only age or lymph node status were significante, but, this is independent for the methods difference of management axillary.The arm oedem showed for radiotherapy alone 2 cases for surgery+irradiation 18 cases. So,to autuer's thinking:For age older than 55 years or N0, the treatement axilly lymph node by radiotherpy with low risk and high qualite surval was reasonable. For younger or N1a, the need for adjuvant therapy (chemotherapy and/or homonotherapy)is obvious. The strong prognostic value of axillary lymph node status in patients with breast cancer overshadow hight side effects after axillary dissction. Thoughe this is a reasonnable conclusion thet positive lymph node is based on the adjuvant therapy. But, with the growing implementation of breast cancer screening programmes, and with the more favourable stage spectrum of newly detected breast cancers, axillary Lymph nords.