乳腺癌术后复发转移的因素分析

Analysis of the factors of the recurrence and metastasis after operation for breast cancer

目的 探讨乳腺癌术后复发转移的相关因素 ,比较不同疗法的疗效。方法 对 4 84例乳腺癌术后复发转移的病例作回顾性分析 ,应用卡方检验比较病期、原发灶大小、淋巴结转移、手术方式、综合治疗等因素对复发转移的影响。结果 复发转移发生于术后 3年内占 85 .5 5 % ,3年后占 14 .5 %。病期越晚复发转移率越高 ,Ⅰ期6 0 .0 % ,Ⅱ期 82 .9% ,Ⅲ期 92 .6 % ,Ⅳ期 10 0 %。病灶 >5cm(96 .6 % )复发转移率明显高于 <2cm(6 9.9% ) ;淋巴结转移 (80 .4 % - 10 0 % )明显高于淋巴结无转移者 (48.1% ) ;单纯手术治疗 (98.5 % )明显高于手术 +放疗 +化疗组(77.7% )。结论 乳腺癌术后的复发转移多发生于术后 3年内。术后定期随访 ,对复发转移者也应做到“三早” ,进行综合治疗 。

Objectives To evaluae the factors relative to recurrence and metastasis after radical operation on breast cancer patients,different treatment has been compared.Methods The retrospective analysis about 484 cases after radical operation has been made.We analyze the factors that affect the recurrence and metastasis including the stage,size of the primary focus,lymphonode metastasis,type of the operation and compound therapy by using χ 2 test.Results The recurrence and metastasis of 414 cases(88.5%) are found in 3 years,70 cases(14.5%) after 3 years.The later of the stage,the higher of the recurrence and metastasis(stage Ⅰ 60.0%,Ⅱ82.9%,Ⅲ92.6%,Ⅳ100%).The rate of recurrence and metastasis for primary tumor>5cm is higher obviously than<2cm,for positive lymphonode higher obviously than negative,only operation higher than compound therapy(operation+chemotherapy+radiotherapy).Conclusions Most of the recurrence and metastasis after operation in breast cancer are found in 3 years.The follow up in period after operation should be done.If the discovery,diagnosis and treatment can be carrid out in early stage,with combined therapy,the prognosis will be improved.