摘要
目的 :研究保乳手术在Ⅰ、Ⅱ期乳腺癌中的治疗效果。方法 :从 1990年 3月到 2 0 0 4年 3月 ,对直径≤3cm ,肿瘤边缘距乳晕≥ 2cm的部分患者施行保乳手术 ,部分肿瘤直径 >3cm的患者先行术前化疗 ,肿瘤缩小后再做保乳手术。手术切除肿瘤周围约 2cm的正常组织 ,达到切缘阴性 ,腋窝清扫范围为Ⅰ、Ⅱ水平淋巴结。开始时应用 1切口设计 ,后来改为 2切口。术后先进行放疗 ,再进行化疗和 (或 )内分泌治疗。结果 :2 6 5例保乳手术腋窝淋巴结清扫数目为 5～ 2 9个 ,平均 16个。本组患者局部复发部位均为乳腺 ,无腋窝复发者 ,三年、五年、十年生存率分别为 99%、94 %、80 % ,局部复发率为 5 .4 %、7%、7.7% ,乳房保留率为 97.8%、93%、88% ,保留乳房的美容效果满意率为 83.2 %。结论 :保乳手术适用于Ⅰ、Ⅱ期乳腺癌患者 ,可以取得良好的生存率、局部控制率和美容效果 ,是乳腺癌治疗的首选术式。
Purpose:To study the effect of breast-conser ving therapy for patients with stage Ⅰ and Ⅱ breast cancer. Methods:From March, 1990 to March, 2004, we performed breast-c onserving therapy for a selected group of patients with tumors less than or equa l to 3 cm and tumor-areola distance more than or equal to 2 cm. Some patients w ith tumors more than 3 cm accepted neoadjuvant chemotherapy and breast-conservi ng therapy was performed after the tumor became smaller. The tumor was excised w ith a normal tissue margin of 2 cm. Axillary dissection included level Ⅰ and Ⅱ . At beginning we performed one excision, then two excision later. After operati on, patients accepted radiotherapy first, then chemotherapy and (or) hormonother apy. Results:In 265 cases, the number of lymph nodes excised was 5- 29, and the average was 16. The local recurrences were all in the breast, and no axillary failure occurred. The 3-year, 5-year, 10-year overall survival rate s were 99%,94%,80% respectively, local recurrence rates were 5.4%,7%,7.7% re spectively, breast-conserving rates were 97.8%,93%,88% respectively. The cosm etic satisfactory rate of the breast was 83.2%. Conclusions:Breast-comserving therapy is recognized as a suita ble treatment for patients with stage Ⅰ and Ⅱ breast cancer, who can achieve a cceptable overall survival rates, local control rates and good cosmetic results. It is the preferential treatment for patients with breast cancer.
出处
《中国癌症杂志》
CAS
CSCD
2004年第6期555-557,共3页
China Oncology
基金
国家十五科技攻关资助项目 (2 0 0 1BA70 3B2 0 )。
关键词
乳腺肿瘤
早期乳腺癌
保乳治疗
breast neoplasm
early breast cancer
breast -conserving therapy
