乳腺癌手术治疗以及综合治疗的效果分析

The effects analysis of operative and comprehensive treatment for breast cancer

目的探讨乳腺癌手术治疗及综合治疗的临床疗效。方法回顾性分析我院自2006年2月～2011年2月收治的85例乳腺癌患者的临床表现、分期、病理分型、肿瘤大小、淋巴结转移情况,并根据患者的实际情况行手术治疗。观察术后的临床疗效及生存率。结果Ⅱ期与Ⅲ期患者共74例,所占的比例为87.07%;病理分型主要是乳腺浸润性导管癌;淋巴结转移率为42.35%;肿瘤直径<3.0 cm者62例,≥3.0 cm者23例。行手术治疗后,甲级愈合72例,5年总生存率为70.59%。其中肿瘤直径<3.0 cm者5年总生存率(87.10%)明显高于肿瘤直径≥3.0者的26.09%(χ2=30.08,P<0.01);无淋巴结转移者5年生存率(83.67%)显著高于淋巴结转移数超过4枚者(35.29%)(χ2=11.49,P<0.01);而年龄≤40岁者5年生存率(36.36%)显著低于40岁以上患者的82.54%(χ2=16.75,P<0.01)。结论对临床Ⅱ、Ⅲ期乳腺癌患者行乳腺癌根治术及肿瘤直径<3.0 cm者行改良乳腺癌根治术加综合治疗可有效提高患者的生存率,是治疗乳腺癌行之有效的方法。

Objective To investigate the clinical efficacy of operative and comprehensive treatment for breast cancer.Methods The clinical presentation,stage,histological type,tumor size and lymph node metastasis of 85 cases with breast cancer from February 2006 February 2011 in our hospital were analyzed retrospectively,the patients were treated by surgical methods in accordance with the actual situation of the patients.The efficacy and survival rate were observed.Results 74 cases were in stageⅡ and Ⅲ,the proportion was 87.07%;pathological type is the mainly invasive ductal carcinoma;the lymph node metastasis rate was 42.35%;62 cases had the tumor diameter 3.0 cm,23 cases had the tumor diameter ≥3.0 cm.After the surgical treatment,the healing cases of grade A were 72 cases.5-year overall survival rate was 70.59%.5-year survival rate of tumor diameter 3.0 cm was 87.10%,higher than 26.09% of tumor diameter ≥3.0 cm（χ2=30.08,P 0.01）;5-year survival rate of no lymph node metastasis was 83.67%,higher than 35.29% of the lymph nodes transferred more than 4（χ2=11.49,P 0.01）;and 5-year survival rate of age ≤40 years was 36.36% lower than 82.54% of the ages over 40 years（χ2=16.75,P 0.01）.Conclusion The implement of breast cancer radical mastectomy for the patients with breast cancer and modified radical mastectomy plus comprehensive treatment for the patients with tumor diameter 3.0 cm can effectively improve the survival rate,and it is an effective way to treat with breast cancer.