早期乳腺癌的手术治疗及预后

Surgical treatment and prognosis of early breast carcinoma

目的 探讨早期乳腺癌的手术方式和预后。方法 对 2 3年间收治并获得随访的 14 9例15 5个早期乳腺癌的临床资料进行回顾性分析。手术方式包括传统根治、仿根治、乳腺全切加低腋淋巴结清除、乳腺单纯切除以及局部切除术。结果 乳腺原位癌 5 ,10 ,15和 2 0年的生存率分别为99 .2 % ,92 .2 % ,86.8%和 85 .7%。早期浸润性乳腺癌 5 ,10 ,15和 2 0年的生存率分别为 10 0 .0 % ,89 .5 % ,70 .0 %和 75 .0 %。各种术式对早期乳腺癌预后的影响不明显 (P >0 .0 5 )。结论 早期乳腺癌的预后可能与乳腺癌的多原发灶有关 ,而与手术方式关系不明显 ;乳腺单纯切除术是早期乳腺癌的首选术式。

Objective To determine the effect of operative approach and the prognosis of early breast carcinoma (EBC). Methods The clinical data of 149 cases of EBC treated in our hospital in the past 23 years were analyzed retrospectively. The operation methods included traditional radical mastectomy, modified radical mastectomy, mastectomy plus low axillary lymphoidectomy, mastectomy, and local mastectomy. Results The 5 , 10 , 15 and 20 year survival rates in the breast carcinoma in situ were 99.2%, 92.2% , 86.8% and 85.7% respectively,and the 5 , 10 , 15 and 20 year survival rates in the early invasive carcinoma of breast were 100%, 89.5%, 70.0% and 75.0% respectively. The operation modes showed little influence on the prognosis of the EBC patients (P>0.05). Conclusions The prognosis of breast cancer may be associated with the multifocal lesions but not related to the operation mode. Simple mastectomy is the first choice for breast carcinoma in situ and early invasive carcinoma of breast.