乳腺癌保乳综合治疗的疗效分析  

Analysis of the therapeutic effect of breast conserving comprehensive therapy for breast cancer

作　　者：毛杰[1] 海健[1] 申正堂[1] 唐利立[1] 邬玉辉[1] 欧慧英[1] 刘少华[1] 

机构地区：[1]中南大学湘雅医院乳腺肿瘤科,湖南长沙410008

出　　处：《中国普通外科杂志》2004年第11期804-807,共4页China Journal of General Surgery

摘　　要：目的　评价I ,IIa期乳腺癌保乳综合治疗的疗效。方法　将 14 1例I ,IIa期乳腺癌 (肿块距乳头≥ 3cm )前瞻性非随机分为两组 :(1)保乳治疗组 68例 ,行保留乳房的肿瘤局部广泛切除加腋窝淋巴结清扫术 ;(2 )对照组 46例 ,行乳癌改良根治术。术后均给予化疗、放疗和 /或内分泌治疗。结果　中位随访 46个月 ,两组病例均无局部复发。保乳治疗组 3a生存率为 98.0 % ,5年生存率为93 .3 % ,远隔脏器转移率为 7.4% ;改良根治组 3年生存率为 97.1% ,5年生存率为 91.3 % ,远隔脏器转移率为 8.7 ,两组各指标比较无明显差异 (P >0 .0 5 )。结论　对癌肿距乳头≥ 3cm的I ,IIa期乳腺癌采用保乳综合疗法 ,可以达到与根治术相似的治疗效果 ,可能逐渐成为治疗I 。Objective To evaluate the therapeutic effect of breast-conserving comprehensive therapy in stage I and IIa breast cancer. Methods Sixty-eight cases of stage I and IIa breast cancer were treated with locally extensive tumor resection breast-conserving surgery plus axillary lymphatic dissection ;the control group consisted of forty-six cases of stage I and IIa breast cancer treated with modified radical mastectomy. All the patients in the two groups were treated with chemotherapy , radiotherapy or endocrinotherapy postoperatively. Results All of the patients were followed up for a median of 46 months. Both groups of patients had no local recurrence; the 3-and 5-year survival rate of breast-conserving group was 98.0% and 93.3% respectively , distant organ metastasic rate was 7.4%; the 3-and 5-year survival rate of modified radical mastectomy group was 97.1% and 91.3%, distant organ metastasic rate was 8.7%. The difference of survival rate and distant organ metastasic rate between the two groups was not significant(P>0.05). Conclusions The therapeatic effect of breast-conserving therapy of stage I,and IIa breast cancer located ≥3cm of the nipple is similar to that of modified radical mastectomy. Breast-conserving therapy can gradually become the operation of first choice for stage I and IIa breast cancer.

关 键 词：乳腺肿瘤/外科学 保留乳房 

分 类 号：R737.9[医药卫生—肿瘤]