乳腺分泌状肿瘤的外科治疗探讨

The Choice of Surgical Therapeutical Methods about Phylloides Tumor of the Breast (PTB)

目的:研究乳腺分叶状肿瘤(PTB)的外科治疗方法选择,观察其预后。方法:在86例病人中,根据PTB的病理性质和生物学行为采用不同的外科术式和辅助治疗,术后跟踪随访,得出良、恶性PTB正确的个性化治疗方法。结果:良性PTB者仪需行单纯肿瘤的完整切除,伴有间质细胞增生者范围扩大至单纯乳房切除术。恶性(包括临界性)需行单纯乳房切除术,必要时增加区域淋巴结清扫术和辅助化疗。体内相关因子的测定,能及早发现乳腺叶状囊肉瘤(CPB)的存在和复发。结论:规范的个性化综合治疗措施能有效地提高疗效,降低PTB术后复发率。

Objective: To study the PTB's surgical treatment! methods and the influence at the choice of right methods to the disease's prognosis. Methods: In 86 cases PTB,according to the different specific pathologic type and biological behavior, we used different surgical operations and adjutant therapeutical measures. For looking for the correct proper therapeutical methods of malignant PTB and benign PTB, we still proceeded to follow with patients after postoperative period. Results: According to the pathologic type,local adequately excision with breast conservation have been only acted in benign PTB and mastectomy would be acted to go with stromal overgrowth. In cystosarcoma phyllodes of the breast (include critical PTB),onefold mastectomy must be acted, and sometimes lymph node must be cleared in interrelated region and added the use of adjuvant anticancer iatric treatment. By measurement of the related factors in body,CPB or its relapse can be discovered early. Conclusion: The integrated individual cure project can increase survivor rate availably and decrease relapse rate after operation.