乳腺癌术后局部复发因素的探讨

Study on local recurrence in breast cancer

目的 :探讨乳腺癌术后局部复发的影响因素。方法:1990年1月至1992年12月天津医科大学肿瘤医院乳腺科共收治女性原发乳腺癌1179例 ,观察肿瘤自身因素和治疗因素对术后局部复发的影响。结果:3年复发率2.3 % (27/1179) ,5年复发率3.4 % (40/1179) ,总复发率4.6 % (54/1179)。肿瘤自身因素中 ,肿瘤家族史、原发肿块大小、腋下淋巴结转移数目对术后局部复发有显著影响 ,而年龄、病理类型、雌激素受体状态对术后局部复发无显著影响。治疗因素中 ,术后辅助放疗对防止复发有一定作用 ,而保乳术后复发率显著高于根治术和仿根治术两组。结论:早期诊断、早期治疗是防止乳腺癌复发转移的有效途径。严格掌握手术适应症 ,改进手术操作 。

Objective:To study the main determinants of local recurrence in breast cancer.Methods:Retrospectively analyzed1179patients with primary breast cancer who underwent breast-conserving treatment or mastectomy and axillary lymph node dissection from1990to1992.Results:The tolal rate of local recurrence was4.6%(54cases).Family history,tumor size,axillary nodal involvement,breast-conserving treatment and without postoperational raˉdiation were the main risk factors of local recurrence,while age,pathologic type and the status of estrogen receptor were not significantly related to local recurrence.Conclusion:Early diagˉnosis and therapy will efficiently decrease the rate of local recurrence in breast cancer.Meanˉwhile,it is our duty to strictly select patients undergo breast-conserving treatment,improve operational technique and adjuvant therapeutic methods.