乳腺癌保乳手术68例分析  

Treatment of breast cancer with breast-conserving therapy(report of 68 cases)

作　　者：刘纯[1] 陈述政[2] 范风风[1] 李振平[1] 

机构地区：[1]浙江省宁波市妇女儿童医院乳腺科,浙江宁波315012 [2]浙江省丽水市中心医院乳腺科,浙江丽水323000

出　　处：《温州医学院学报》2006年第6期563-565,共3页Journal of Wenzhou Medical College

摘　　要：目的:探讨保乳手术在乳腺癌治疗中的应用。方法:回顾性分析1997-2005年间完成的女性乳腺癌保乳手术68例资料。手术指征:肿瘤≤3.0cm的临床Ⅰ期、Ⅱ期乳腺癌;单发病灶,X-线钼靶片无广泛钙化;肿瘤边缘到乳晕边缘距离≥2.0cm;肿瘤与乳房比例适度;病人有保乳意愿。手术方式为局部广泛切除加腋淋巴清扫。术后辅助放疗、化疗和内分泌治疗。结果:术后标本病理切片检查,切缘无癌细胞浸润。经2～99个月(中位31个月)随访。65例健康存活,2例因复发转移死亡,1例带瘤生存,总生存率达95.5%。对综合治疗满一年的45例进行乳腺外形效果评定:优17例,良22例,差6例,优良率达86.7%。结论:保乳手术,适用于治疗早期、Ⅰ期和部分肿瘤≤3.0cm的Ⅱ期乳腺癌,疗效满意。Objective：To investigate the indications and results of breast conserving therapy （BCT） Methods：Sixty-eight pationts with breast carcinomas underwent BCT were retrospectively analyzed from January 1997 to December 2005. The indications include：① The tumor size ≤3.0 cm in diameter and classification with stage I and pact of stage Ⅱ patients; ② The multicentre cancer or the extensive calcification were exclude by preoperative mammograms; ③ The distance between tumor edge to aerolar edge was≥2.0 cm; ④ The ratio of tumor and breast was appropriate; and ⑤ Patient had the desire to preserve her breast. The manner of surgical tretment was wide excision of tumor or quadrantectemy plus axillacy dissection. Adjuvant irradiation,chemotherapy and hormone therapy were given postoperatively. Results： The breast specimens were examined and no infiltrating margin was found.The median time of follow-up was 37 months （range 2 - 99 months）. Sixty-five cases healthily surrived. Local recurrence were found and died in 2 cases. Cerebral metastasis was found but still survived in 1 case. About 86.7% patients who received BCT 12 months previously showed good cosmetic results. Conclusion： For early stage breast carcinoma and part of local advanced breast cancer,the result of BCT is satisfactory. The keys are standard excision, postoperative irradiation and systemic treatment are crucial to BCT.

关 键 词：乳腺癌 外科手术 保乳治疗 

分 类 号：R737.9[医药卫生—肿瘤]