早期乳腺癌保乳手术175例回顾性分析  

Breast conservation surgery for early breast cancer:an analysis of 175 cases

作　　者：裴炜[1] 宣立学[1] 高纪东[1] 王翔[1] 张保宁[1] 赵平[1] 

机构地区：[1]中国医学科学院肿瘤医院腹部外科,北京100021

出　　处：《中国实用外科杂志》2008年第11期964-966,共3页Chinese Journal of Practical Surgery

基　　金：国家"十五"科技攻关基金资助项目(2001BA703B20)

摘　　要：目的探讨影响乳腺癌保乳手术后局部复发的预后因素。方法对中国医学科学院肿瘤医院腹部外科2001年1月至2004年12月间收治的175例早期乳腺癌保乳手术资料进行回顾性研究,对年龄、分期、切缘、肿瘤大小、淋巴结情况等指标做单因素和多因素分析。结果中位随访时间57(18～94)个月。全组5年的总存活率和无病存活率分别为96.4%和91.1%,局部复发率1.7%。单因素分析显示保乳手术后局部复发危险因素包括肿瘤直径>3 cm、切缘<2mm以及TNM分期。结论早期乳腺癌行保乳治疗是安全的,但要掌握保乳手术指征,保证术后综合治疗。Objective To investigate the prognostic factors for local-regional recurrence in patients treated with breast conservation surgery. Methods The clinical data of 175 patients treated with breast conservation surgery registered between January 2001 and December 2004 at Cancer Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively. The prognostic factors of age, staging, margin, tumor size, lymphatic node, ER, PR, HER2, adjuvant therapy were analyzed by univariate and multivariate factors analysis of log-rank and Cox regression model. Results The median follow-up time was 57 months. The overall survival rate and disease-free survival rate at 5 years were 96. 4% and 91.1% respectively. The local-regional recurrence rate was 1.7%. It was concluded that tumour size （ 〉 3cm） ,TNM staging and close/positive final margins （ 〈 2mm） were significant independent predictors for local-regional recurrence. Conclusion If the surgical indication and the necessary safe margin in resection of conservation surgry is obeyed by and followed in combined therapy, conservative surgry is safe and satisfactory in the treatment of early breast cancer.

关 键 词：乳腺肿瘤 保乳手术 局部复发 

分 类 号：R6[医药卫生—外科学]