乳腺癌的位置与血液供应及其与术前介入化学药物治疗效果的关系

A study on the relationship of tumor location and blood supply in breast cancer patients and the effect of preoperative intraarterial chemotherapy

目的探讨乳腺癌的位置与血液供应及其与术前介入化学药物治疗（下称化疗）疗效的关系。方法应用Ｓｅｌｄｉｎｇｅｒ技术对１５例Ⅲ期乳腺癌患者造影，并经乳腺癌癌灶供血动脉采用顺铂、阿霉素、丝裂霉素和５氟尿嘧啶（ＰＡＭＦ）进行灌注化疗。结果乳腺癌的肿瘤供血与部位有关：外侧病灶１１例主要由胸外侧动脉供血，内侧病灶４例主要由胸廓内动脉供血。乳腺癌采用ＰＡＭＦ进行介入化疗后，肿瘤及腋窝淋巴结明显缩小，根治术后１５例均获随访，随访时间２～６年，７例生存期达５年以上，仅２例于术后３年后复发，与同期Ⅲ期乳癌未作介入化疗者相比，复发率明显降低，差异有非常显著意义（Ｐ＜００１）。结论晚期乳腺癌如无化疗禁忌症，应考虑作术前介入化疗，以提高疗效。介入化疗时应仔细全面观察。

Objective To investigate the relationship between tumor location and blood supply in breast cancer patients and the effect of preoperative intraarterial chemotherapy basing on the findings by angiography.Method Seldinger procedure was used to perform angiography in 15 breast cancer patients of stage Ⅲ and intraarterial chemotherapy with PAMF (DDP,ADM,MMC,and 5 Fu) was given.Result It was found that the blood supply varied with the location of the tumor foci,and the lateral foci in 11 cases was supplied mainly by arterial thoracalis lateralis and the internal foci in 4 cases by arterial thoracica interna.The primary tumor foci and the axillary metastatic LN all reduced after the chemotherapy.All patients underwent radical mastectomy afterwards and were all followed up for 2 to 6 years with 7 still alive for more than 5 years.Recurrence was found in 2 on 3 years post op,which was significantly lower than that in those not receiving preoperative intervensive chemotherapy ( P <0 01).Conclusion Preoperative intraarterial chemotherapy through the major blood supplying artery found by angiography should be given to late staged breast cancer patients to the effect that the long term suvival rate could be elevated.