新辅助化疗后保留乳房手术治疗进展期乳腺癌可行性分析

The feasibility analysis of breast conserving surgery after neoadjuvant chemotherapy in the treatment with advanced breast cancer

目的对新辅助化疗后保留乳房手术治疗进展期乳腺癌行可行性分析。方法收集2010年6月—2011年6月间进展期乳腺癌患者60例，根据患者意愿分为新辅助化疗后保乳手术组和改良根治术组，每组30例，分别给予新辅助化疗后保乳手术及改良根治手术，随访3年。比较两组的治疗效果，并分析两组乳腺癌循环肿瘤细胞（CTCs）阳性情况，记录两组患者随访后期局部复发率、远处转移率、总生存率和无瘤生存率。结果新辅助化疗后保乳手术组与改良根治术组相比，两组CTCs检出率没有统计学差异（P〉0．05），两组患者在临床完全缓解率、部分缓解率、疾病稳定率以及局部复发率、远处转移率、总生存率和无瘤生存率方面均无统计学差异（P〉0．05）。结论对进展期乳腺癌患者应用新辅助化疗合并保乳手术治疗，能达到与改良根治术类似的治疗效果，可作为治疗进展期乳腺癌的一种选择。

Objective To analyse the breast conserving surgery feasibility in patients with advanced breast cancer after neoadjuvant chemotherapy. Methods Sixty patients with advanced breast cancer were collect- ed from June 2010 to June 2011, and were divided into breast conserving surgery after neoadjuvant chemotherapy group and modified radical mastectomy group according to the intention,30 cases in each group. They were given breast conserving surgery after neoadjuvant chemotherapy and modified radical mastectomy respectively, with fol- lowing - up for 3 years. The treatment effect and contrast analysis of two groups of breast cancer CTCs positive of the two groups were compared, two groups of late follow - up of patients with local recurrence and distant metasta- sis rate, overall survival and disease free survival rate were recorded. Results Compared with the modified radi- cal mastectomy group, CTCs detection rate in breast conserving surgery group had no statistical differences （P 〉 O. 05）. Two groups of patients in clinical complete remission rate, partial remission rate, disease stability factor and local recurrence and distant metastasis rate, overall survival and disease free survival rate had no statistical significances （P 〉 0.05）. Conclusion The application of breast conserving surgery after neoadjuvant chemother- apy for patients with advanced breast cancer can achieve similar effect as modified radical mastectomy surgery treatment, and can be used as a effective treatment for advanced breast cancer.