53例早期乳腺癌保乳治疗临床分析

Clinical analysis of breast conservation surgery for early breast cancer in 53 cases

目的探讨早期乳腺癌保乳治疗的手术处理方法及近期疗效。方法 2005年6月至2009年10月共收治女性乳腺癌患者276例,对其中Ⅰ~Ⅱ期原发乳腺癌施行保乳手术治疗,手术方式采用乳腺局部肿物扩大切除加同侧腋窝淋巴结清扫术或同侧前哨腋窝淋巴结活检术,术中对肿物进行切缘冰冻快速病理检查,术后患侧乳房接受放射治疗。结果 53例患者成功实施了保乳手术,手术后随访6个月,对保留乳房治疗的满意率达99%,十分满意占90%,与腋窝前哨淋巴结活检术结合进一步降低了患侧上肢淋巴水肿等并发症的发生,提高了患者的生活质量。经随访2~52个月,中位随访17个月,无乳腺局部复发病例,无远处转移及死亡病例。结论Ⅰ~Ⅱ期乳腺癌保乳治疗近期疗效满意,相关手术的处理方法可行,远期疗效有待长期随访观察。

Objective To investigate the treatment methods and short-term curative effects of breast-conservation therapy for early primary breast carcinoma.Methods 276 women cases of breast cancer were accepted and treated during June 2005-Oct 2009,and some patients with stage Ⅰ-Ⅱ primary breast cancer were treated with breast conservation surgery.Wide local excision and axillary lymph node dissection or ipsilateral axillary sentinel lymph node biopsy were performed and rapid pathological examination of frozen section of surgical margin was done during the operation.After operation the affected breast received radiation therapy.Results Fifty-three patients with primary breast cancer were treated successfully with breast-conservation therapy.The 6-months follow-up results after the operation showed that 99% patients were satisfied with the efficacy of the breast-conservation therapy and 90% patients were very pleased with that.Incidence of complications such as upper extremity lymphedema was reduced by combining with the ipsilateral axillary sentinel lymph node biopsy and the living quality of patients was improved.After a median follow-up of 17（2-52） months,no local recurrence of cancer,distant metastasis and fatal cases occurred.Conclusion Satisfactory short-term curative effect is obtained in breast-conservation therapy for patients with stage Ⅰ-Ⅱ primary breast cancer and the treatment method of operation is feasible.Long-term curative effects need to be observed by a long-term follow-up.