手术治疗在乳腺癌综合治疗中的地位

Role of surgery in multidisciplinary treatments of breast cancer

非手术治疗技术的进展使乳腺癌局部和全身控制的效果进一步提高，但是手术治疗仍具有重要作用。早期乳腺癌可选择保乳治疗（部分可选择经乳晕切口的保乳术）、保留皮肤的乳房切除加即刻再造或改良根治术等个体化治疗。局部晚期的乳腺癌可先行新辅助治疗，然后行外科手术治疗。复发、转移乳腺癌的手术治疗对于控制局部症状、改善生活质量具有重要意义，最近的研究还表明可以带来生存获益。目前乳腺癌治疗策略仍然是以外科手术为主的综合治疗，无论从提高生存率还是改善生活质量方面来看，外科手术在乳腺癌的多学科治疗中仍占据核心地位。

Though the development of non-surgical treatments has improved the local and systemic control of breast cancer, surgery still plays an important role. For early breast eancer, breast-conserving surgery （via periareolar incision and/or axillary ineision for some suitable eases）, skin-sparing mastectomy with immediate breast reconstruction and modified radical masteetomy can be chosen individually. For locally advanced breast cancer, neoadjuvant therapy followed by surgery is recommended. Surgery can improve local control and life quality for recurrent and metastatic breast cancer; furthermore, recent evidence also shows some survival benefits. At present, the treatment strategy of breast cancer is surgery-based multidisciplinary approach, and surgery is still the mainstay of treatment no matter in survival and fife-quality improving.