156例早期乳腺癌保乳治疗的回顾性分析

Retrospective Analyses of 156 Patients with Early-Stage Breast Received Breast-Conserving Surgery Treatment

目的对早期乳腺癌保乳手术加辅助治疗的美容效果及近期疗效进行观察。方法回顾性分析日照市人民医院1998～2005年收治的156例Ⅰ～Ⅱa期实施保乳治疗的乳腺癌患者。所有患者均行乳房肿块局部扩大切除及腋窝淋巴结清扫术,术后均接受放射治疗58～60 Gy,并对浸润性乳腺癌患者行辅助化疗4～8周期。化放疗结束后,对激素受体阳性患者行三苯氧胺或来曲唑等内分泌治疗,对患者乳房外形进行评价,对生存情况进行随访。结果手术并发症发生率为15.4%,乳房外观评价为优良、一般和较差分别为102例(65.4%)、50例(32.1%)和4例(2.5%)。患者3年总生存率为95.5%,3年无病生存率为92.3%,局部复发率为6.4%。结论保乳手术治疗早期乳腺癌疗效确切,术前严格掌握手术适应证及术后行规范的辅助治疗是保乳手术获得良好疗效的保证。

Objective To evaluate the short-term curative effects and cosmetic effects of breast-conserving surgery plus adjuvant therapy on patients with early-stage breast cancer.Methods One hundred and fifty six patients of breast cancer in stage Ⅰ-Ⅱa treated with breast-conserving surgery from 1998 to 2005 were analyzed retrospectively.All patients were treated with breast lumps local expand resection and axillary lymph node dissections and radiotherapy 58-60 Gy,and those with invasive breast cancer were done adjuvant chemotherapy 4-8 cycles,after chemoradiation,those with hormone receptor-positive received tamoxifen or letrozole hormone therapy.Breast appearances were evaluated and survival conditions were followed-up.Results The surgical complications incidence rate of all cases was 15.4%,and cosmetic effects of all patients were classed into three grades：good（65.4%）,fair（32.1%） and poor（2.5%）.The 3-year overall survival rate of all cases was 95.5%,and 3-year disease-free survival of that was 92.3%,and total local recurrence rate was 6.4 %.Conclusion The breast-conserving surgery is effective in early-stage breast cancer;however,the strict control of preoperative indications as well as the postoperative standardized adjuvant therapy will be a guarantee of good efficacy for breast-conserving surgery.