早期乳腺癌保留乳房手术加放疗63例疗效观察

Long Term Results of Breast-Conserving Operation Plus Radiotherapy on 63 Patients with Early Breast Cancer

目的：观察早期乳腺癌保留乳房手术配合术后放疗的远期生存和美容效果。资料与方法：１９８９年１月至１９９４年３月共收治早期乳腺癌６３例，其中１期２２例，１１期４１例。行单纯肿瘤切除加腋窝淋巴结清扫，术后配合放疗。全乳腺切线照射４５～５０ Ｇｙ，瘤床加用电子线照射 １５～２０ Ｇｙ。腋窝淋巴结阳性者同时照射相应的淋巴引流区４５～５０Ｇｙ。结果：５年、１０年生存率分别为９２．１％和８７．３％。仅１例发生放射性肺炎症状，美容效果满意。结论：保留乳房手术，术后配合放射治疗早期乳腺癌的效果与根治手术大致相似。对符合条件的Ⅰ、Ⅱ期病例，此种方法可以作为首选治疗手段。

Objective: This study was designed to evaluate the efficacy of breast conserving operation plus radiotherapy. Methods: From January 1989 to march 1994, 63 cases with early breast cancer, among them, 22 cases were in Stage Ⅰ, 41 cases in Stage Ⅱ were treated using breast-conserving surgery plus radiotherapy. Tangential field irradiation was used with dose of 45 Gy - 50 Gy. Tumor bed was irradiated additional 15 gray - 20 gray with electron beam. ResultS: The 5 and 10 years survival rates were 92. l% and 87. 3% respectively. In all of 63 patients, only I cases developed radiation induced pneumonitis. The cosmetic effects were satisfactory for all patients. Conclusion: In early stage of breast cancer, the effects of breast-conserving operation plus radiotherapy were simitar to that of radical mastectomy. Thus for legible early stage breast cancer breast-conserving therapy could be the first choice.