中央区乳腺癌的保乳治疗  

Breast-conserving therapy for centrally located primary breast cancer

作　　者：李金锋[1] 欧阳涛[1] 王天峰[1] 解云涛[1] 范照青[1] 林本耀[1] 

机构地区：[1]北京大学临床肿瘤学院北京肿瘤医院乳腺中心,100036

出　　处：《中华肿瘤杂志》2006年第6期478-480,共3页Chinese Journal of Oncology

基　　金：北京市卫生局重点学科基金(1998卫科重字10号)

摘　　要：目的探讨中央区乳腺癌保乳治疗的可行性。方法对157例肿瘤位于乳房中央区的Ⅰ～Ⅱ期及新辅助化疗后的Ⅲ期原发性乳腺癌患者,行局部扩大切除并腋窝淋巴结清扫手术,其中18例切除乳头乳晕区。手术前,93例接受2～6周期的新辅助化疗。手术后,全部患者的患乳接受放射治疗。结果接受新辅助化疗的患者,临床有效率为87．1%(81/93),术后病理学完全缓解率15．1%(14/93)。全部患者成功施行保乳治疗后,经随访6～53个月(中位随访23个月),仅1例局部复发。保乳治疗后对患侧乳房外观的评价：88例优秀,48例良好,21例一般,总体优良率86．6%。结论位于中央区的Ⅰ～Ⅱ期原发性乳腺癌患者,同样适合实施保乳治疗,近期疗效满意,远期效果有待长期随访观察。Objective The goal of the study is to investigate the feasibility of breast-conserving therapy for early primary breast carcinoma centrally located in the breast. Methods 157 patients with stage Ⅰ or Ⅱ primary breast cancer located in the central part of the breast were operated with extended local excision and axillary lymph node dissection. Nipple-areola complex was excised in 18 patients. Ninety-three patients received two to six cycles neo-adjuvant chemotherapy. Radiotherapy was given postoperatively to the whole remaining breast. Results The clinical response rate was 87, 1% （81/93） and pathologic complete remission rate was 15, 1% （ 14/93 ） after neo-adjuvant chemotherapy. Breast conservation surgery was performed successfully for all the patients in this series. After a median follow-up of 23 months （ range 6-53 months）, there was no recurrence in the ipsilateral breast. The aesthetic effect of the conserved breast was satisfactory including excellent for 88 patients and good for 48 patients representing of 86.6% of all cases, Conclusion Breast conserving surgery is suitable for the early centrally located primary breast carcinoma. Though the short-term results are satisfactory, the long-term follow-up is still needed for the final outcome.

关 键 词：乳腺肿瘤 保乳治疗 淋巴结清扫术 

分 类 号：R737.9[医药卫生—肿瘤] R779.6[医药卫生—临床医学]