中国女性乳腺癌保守治疗及美学相关因素研究

Cosmetic studies on conservative therapy in Chinese women with breast cancer

目的 探讨中国女性乳腺癌保守手术的“安全边缘”及符合美学要求的保守治疗适应症。方法 以临床Ⅰ、Ⅱ期乳腺癌根治术标本作卫星灶空间分布分析 ,以期发现合理的安全边缘。对切除组织体积和乳房体积数据作比较分析 ,以确定适合中国女性乳腺癌保守治疗的适应症。结果 75 %的病例的卫星灶分布于距原发灶 2 .0cm的范围内。原发灶小于 2 .0cm者体积丢失均小于 2 0 %;当乳房体积分别大于 32 1ml和 339ml时 ,2 .1～ 2 .5cm及 2 .6～ 3 .0cm的肿瘤其体积丢失小于 2 0 %。结论 对中国女性早期乳腺癌患者而言 ,保守手术切缘应至少离肿瘤 2 .0cm ;从美学角度来看 ,不超过 2 .0cm的肿瘤为保守治疗最佳适应证 ,乳房大于 32 1ml和 339ml时 ,不超过 2 .5cm和 3 .0cm的肿瘤可作保守治疗。肿瘤大于 3 .0cm者 ,除非乳房体积较大 ,一般不宜作保守治疗。

Objective To study conservative surgical margin and tumor size that is suitable for conserving therapy in Chinese women with breast cancer.Methods The studies were calrried out in mastectomy specimens of 80 patients,clinically assessed as stage Ⅰ Ⅱ,who were comparable to those eligible for breast conserving surgical therapy.Distribution of tumor foci was studied to find out the rational surgical margin.And the volume of mamma and excised tissue were also studied to find out the indication of breast conserving therapy in Chinese women.Results To Chinese women with breast cancer,2cm as the minimum conserving surgical margin is reasonable.The ratios of lost volume tumors with a margin less than 2cm in size were all less than 20%.In patients whose tumor sizes were 2.0～3.0cm,the removed volume was positively correlated with mammary volume.When mammary volume was more than 321ml to 339ml,the lost volume ratios of tumors with a margin less than 2.1～2.5cm and 2.6～3.0cm were all less than 20%.Conclusions Conservative surgery margin is at least 2.0cm reference to Chinese women with early breast carcinoma.when mamma is larger than 321ml and 339ml,and tumors less than 2.5cm and 3.0cm,it is suitable for conservative therapy.when larger than 3.0cm it is not suiable unless the mamma is too big. [