保留乳腺治疗临床Ⅰ、Ⅱ期乳癌体会

Conserving breast therapy for stageⅠ,Ⅱbreast carcinoma

目的 :讨论保留乳腺治疗乳癌的可行性。方法 :对 15例临床Ⅰ、Ⅱ期乳癌患者实施了乳癌区段切除加同侧腋窝淋巴结清扫术 ;术后辅以化疗 ,放疗 ,或抗雌激素 (TAM)治疗。结果 :13例获随访 ,2例失随访。 4例患者随访 10～ 14年 ,6例随访 8～ 9年 ,3例随访 5～ 7年。所有患者随访期内存活 ,其中 1例于术后 4年 10个月患侧乳癌局部复发 ,行患乳单纯切除 ;术后 6年 7个月发现对侧腋淋巴结转移而行乳癌改良根治术 ,随访 10年仍健在。全组患者无病生存率 92 .31% ,复发率7.69% ,治疗效果不低于乳癌改良根治术。结论 :保留乳腺治疗临床Ⅰ、Ⅱ期乳癌可作为同期乳癌根治性手术的替代术式。

Objective:To explore the feasibility of conserving breast therapy for stageⅠ,Ⅱbreast carcinoma.Method:Fifteen cases underwent breast_conserving surgery,followed by radiotherapy, chemotherapy or TAM treatment. Results:Thirteen cases were followed up and 2 cases were lost to follow up. 4 cases were followed up for 10-14 years, 6 cases for 8-9 years, and 3 cases for 5-7 years. All of the patients survived during follow_up period.Four years and 10 months after the first operation, one patient had local recurrence,with a recurrence rate of 7.69% (1/13), and mastectomy was performed,six years and 7 months after the first operation, the opposite axillary lymph node metastasis was found and the modified radical mastectomy was performed.Now it is more than 10 years since the first operation,the patient is still living.The disease_free survival rate was 92.31% (12/13). Conclusion: The breast conserving therapy is a reasonable alternative to radical mastectomy for patients with stageⅠ,Ⅱ breast carcinoma.