乳腺癌保乳手术不同瘤距对切缘状态及美容效果的影响  

Effect of the different range of incisal margin to the surgical margin status and cosmetic effect in breast conservation surgery

作　　者：王永霞[1] 张爱玲[1] 陈彩芹[1] 张蓉[1] 钟慕仪[1] 袁领勤[1] 

机构地区：[1]东莞市人民医院乳腺科,广东东莞523018

出　　处：《赣南医学院学报》2008年第3期370-372,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：东莞市科技局资助项目(2007105150011)

摘　　要：目的：评价乳腺癌保乳手术不同瘤距对切缘状态及美容效果的影响。方法：对48例符合保乳指针并有保乳意愿的乳腺癌患者进行保乳术，术中根据测量大体标本切缘距瘤缘，分瘤距为1～2cm组和瘤距为2～3cm组，行术中全周切缘冰冻病理检查，术后12月依照美容评定标准评价患侧乳房美观满意度，术后行放化疗及内分泌治疗。结果：瘤距1～2cm组26例，切缘阳性率11．5％（3／26）；瘤距2～3cm组22例，切缘阳性率4．5％（1／22），两组比较在乳腺癌切缘阳性率方面1～2cm组稍高，但差异无统计学意义（P〉0.05）。4例予以扩大切除后2例切缘阴性，归于2～3cm组，2例仍切缘阳性而放弃保乳手术。两组术后12个月美容效果方面比较差异有统计学意义，瘤距1～2cm组优于2～3cm组。随访1年两组均未见局部复发与远处转移。结论：保证切缘阴性，切缘距肿瘤缘1～2cm是保乳手术的合理肿瘤切除范围，可获得良好美容效果。Objective：To evalua te the influence of the different range of incisal margin on the surgical margin status and cosmetic effect in breast conservation surgery. Methods： Forty ＇ eight patients who had the desire and entitled to preserve her breast were given breast conservation surgery. They were devided into two groups（ group 1-2cm and group 2-3cm） according to the range of ineisal margin,intraoperative frozen section in surgical margin, assessment of cosmetic results was carried out in patients who had received breast conserving surgery 12 months postoperatively, radiotherapy, chemotherapy and endocrinotherapy after breast conservative surgery. Results：margin positive rate was 11.5% （3/26）in group 1-2cm（26 cases） , group 2-3cm（22 cases） was 4.5% （1/22） ,Margin positive rate of group 1-2cm was slightly higher than that of group 2-3cm, but had no statistical significance（P〉0.05）.In enlarged resection of 4 cases,2 cases was ascribe to the group 2-3cm,otbers were out. The difference of cosmetic effect 12 months postoperatively between the two groups had statistical significance （P〈0.05）, group 1-2cm was better than group 2-3 cm. no local recurrence or distant metastasis was found in all cases in the following up of I year. Conclusion：Ensuring negative margin,1-2cm incisal margin is rational range in breast conserving surgery,which can acquire better cosmetic effect.

关 键 词：乳腺癌 保乳术 瘤距 手术切缘 美容效果 

分 类 号：R737.9[医药卫生—肿瘤]