早期乳腺癌局部肿块切除术后的保乳手术  

Breast Conserving Surgery in Patients with Early Breast Cancer After Local Lumpectomy

作　　者：徐发良[1,2] 王文彦[3] 王翔[3] 

机构地区：[1]重庆市肿瘤研究所 [2]重庆市肿瘤医院乳腺疾病治疗中心,重庆400030 [3]中国医学科学院北京协和医学院肿瘤医院乳腺外科,北京100021

出　　处：《中国微创外科杂志》2014年第7期577-579,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的：探讨乳腺癌肿块局部切除后行保乳手术的可行性和安全性。方法回顾性分析2009年1月～2011年12月26例在外院行乳腺肿块局部切除后要求行保乳手术的乳腺癌患者临床资料，均为单发浸润性导管癌，术前分期为T1 N0 M0。局部切除至保乳手术间隔6～24 d，平均10 d；术前肿块直径1～2 cm，平均1．6 cm；原手术切口至乳头的最短距离2～6 cm，平均4．5 cm。结果26例均顺利完成保乳手术，联合前哨淋巴结活检术15例，腋窝淋巴结清扫术11例。手术切口全部Ⅰ期愈合，住院时间3～5 d。术后均完成全乳放疗。随访2～5年，中位随访时间32个月，未发现局部复发和远处转移，乳房外观及生活质量满意。结论对已行乳腺癌肿块局部切除但具备保乳条件、且有保乳愿望的患者，如果掌握比常规保乳手术更加严格的适应证，可以施行保乳手术。Objective To explore the feasibility and safety of breast conserving surgery （ BCS） in patients with early breast cancer after local lumpectomy . Methods Clinical data of 26 patients who previously had received local lumpectomy from January 2009 to December 2011 were retrospectively analyzed .All the patients were diagnosed as solitary invasive ductal carcinoma with preoperative staging of T1N0M0.The interval from lumpectomy to BCS was 6-24 days （mean, 10 days） and the maximum diameter of tumors before first operation was 1-2 cm （mean, 1.6 cm）.The shortest distance between nipple and operative incision was 2-6 cm （mean, 4.5 cm）. Results The operations were successfully completed in all 26 patients, 15 of which received sentinel lymph node biopsy and 11 of which received axillary lymph node dissection .The hospital stay was 3-5 days with stage-Ⅰhealing of incision .All patients received whole breast radiation therapy after BCS .There was no local recurrence or distant metastasis during 2 -5 year ’ s follow-up （median, 32 months）.All the patients were satisfied with the shape of breast and the quality of life . Conclusion For those patients with early breast cancer who have received local lumpectomy , meet the requirement of CBS , and have the willing of breast conserving , BCS is an ideal choice after rigid application of surgical indications .

关 键 词：乳腺癌 保乳手术 局部切除术 

分 类 号：R737.9[医药卫生—肿瘤]