乳腺癌根治手术关键问题  

Key issues of radical surgery for breast cancer

作　　者：刘荫华[1] 周思成 向泓雨 辛灵[1] LIU Yin-hua;ZHOU Si-cheng;XIANG Hong-yu(Department of Thyroid and Breast Surgery,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院甲状腺乳腺外科,北京100034

出　　处：《中国实用外科杂志》2024年第1期43-46,共4页Chinese Journal of Practical Surgery

基　　金：北京奖励基金会项目(No.YXJL-2020-0941-0736);中国乳腺外科青年医师研究项目(No.2020-CHPASLP-01,No.CJBSRAF-2022)。

摘　　要：1894年Halsted报道切除全部乳腺、胸大、小肌联合腋窝淋巴结清扫的乳腺癌根治手术使乳腺癌病人5年生存率达到40%。历时近130年,Halsted手术方式作为肿瘤经典根治术载入乳腺癌外科的历史。20世纪70年代,以提高生存质量为目的的Patey,Auchincloss等改良根治手术方式,以Halsted术式为对照组完成了生存获益的非劣效研究,并成为70%以上中国早期乳腺癌病人接受的常规手术方式。进入21世纪以来,伴随乳腺癌诊治理念的更新,保留乳房手术联合放疗,前哨淋巴结活检阴性豁免腋窝淋巴结清扫所带来的临床获益得到广泛认同。乳腺癌根治性手术的基本理念也被赋予了新的内涵。科学解读乳腺癌根治性手术的基本定义和基本问题是推动并提高乳腺癌临床同质化诊疗水平的关键。In 1894,Halsted described radical mastectomy could improve 5-year survival of patients with breast cancer to 40%operation by removal of breast,axillary lymph nodes and both pectoralis muscles.For the later 130 years,Halsted radical mastectomy had been recorded in the history of breast surgery as a classical radical operation.In 1970 s,modified radical mastectomy of Patey or Auchincloss,which improved the quality of patients'life,was proved no inferior to Halsted radical mastectomy in survival benefits,and became the most common procedure implemented for more than 70%patients with breast cancer in China.Since the beginning of 21st century,with the renewal of the concept of diagnosis and treatment of breast cancer,breast conserving-surgery combined with radiotherapy,omitting axillary lymph node dissection if sentinel lymph node is negative,have been widely recognized for their clinical benefits.The concept of radical surgery for breast cancer has been updated.Scientific interpretation of radical surgery for breast cancer is the key to promote clinical homogenization for diagnosis and treatment of breast cancer.

关 键 词：乳腺外科 根治性手术 规范化诊治 

分 类 号：R6[医药卫生—外科学]