0～Ⅱ期乳腺癌外科保守治疗的疗效观察  

Conservative Surgery for Early Breast Cancer

作　　者：石松魁[1] 郎义芳[1] 傅西林[2] 李瑞英[3] 方志沂[1] 宁连胜[1] 马淑资[1] 李云英[1] 刘俊田[1] 朱元喜[1] 

机构地区：[1]天津医科大学附属肿瘤医院乳腺科,天津市300060 [2]天津医科大学附属肿瘤医院乳腺病理研究室,天津市300060 [3]天津医科大学附属肿瘤医院放疗科,天津市300060

出　　处：《中国肿瘤临床》2002年第1期46-48,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨早期乳腺癌保守性外科治疗的效果。方法:我院1990年6月～2000年4月对临床早期癌125例行乳房象限切除术加腋淋巴结清扫术,其中0期3例,Ⅰ期89例,Ⅱ期33例。全组患者术后乳房放疗102例,未放疗23例。浸润性癌围手术期化疗7周。腋淋巴结阳性术后常规放疗,此后6～12个月内追加12～16次化疗。ER阳性服用TAM2～5年。此外,选用同期0、Ⅰ、Ⅱ期仿根治术或根治术常规综合治疗95例做对照观察。结果:1)病理检查:125个象限切除标本中断端阳性10例(8.0%),均以管内癌形式出现。腋淋巴结平均检出16.8枚,阳性率15.2%;2)生存情况:125例随诊,>3年85例,>5年63例,全部生存。仅1例术后2.5年局部复发,1例术后2年骨转移带瘤生存;随诊<3年40例,1例术后1年肺转移带瘤生存;对照组95例,1例肺转移死亡。结论:早期乳腺癌保守性外科治疗与仿根治术,根治术效果相似且能保持乳房良好外形,是Ⅰ、Ⅱ期乳腺癌理想的治疗方法。Objective:To study the result of early breast cancer treatment by conservative surgery.Methods:From June1990to April2000,125cases of early breast cancer were operat-ed by quadrantectomy and axillary dissection.Among them,stage0(T 0 N 0 M 0 )was3cases,stageⅠ(T 1 N 0-1 aM 0 )89cases and stageⅡ(T 2 N 0-1 aM 0 )33cases.Of all patients,102cases underwent postoperative radiotherapy for the breast.In invasive cancer,perioperative chemotherapy was car-ried out for7weeks.LN positive patients received routine postoperative radiotherapy,then in half or one year,4courses of chemotherapy were added.ER(+)patients took TAM in2-5years.In ad dition95cases in the same time were chosen as control group during1991to1993,they were op erated by modified or radical mastectomy and routine combination treatment in clinical stage0?Ⅰ?Ⅱpatients.Results:(1)Pathiological findings:Of 125specimens from quadrantectomy,cut -ting margin were positive in10cases(8%)and the lesions were intraductal cancer in these cas-es.The mean positive rate of axillary lymph node metastases was15.2%(16.8nodes);(2)Sur-vival condition:Of 125cases85cases were followed up over3years,63cases over5years.One of them had local recurrence in2years postoperatively;40cases were followed up less than3years,and one case developed lung metastasis.Conclusion:The results of conservative surgical treatment are similar to the modified or radical mastectomy and the shape of breast could keep good.For clinical stageⅠ?Ⅱbreast cancer,conservative surgery is recom mended.

关 键 词：乳腺肿瘤 保守手术 综合治疗 乳腺癌 疗效 

分 类 号：R737.9[医药卫生—肿瘤]