保乳手术加放疗治疗早期乳腺癌的初步研究  

A Study on Surgical Treatment of Early-stage Breast Cancer with Breast-conserving Operation

作　　者：傅建民 李先明 潘凯 麦沛成 

机构地区：[1]暨南大学医学院第二附属医院深圳市人民医院,广东深圳518020

出　　处：《中国医师杂志》2004年第1期80-81,共2页Journal of Chinese Physician

摘　　要：目的　研究保留乳房手术加放疗治疗早期乳腺癌的可行性和推广这种术式的可能性。方法　 1999-11～ 2 0 0 1-10 ,对临床Ⅰ ,Ⅱ期乳腺癌病人 ,实施了保乳手术。术前检查明确有无手术指征 ,按自愿选择的原则采用保乳手术。原发灶做局部广泛切除 ,术后常规行根治性放疗。于放疗前和放疗后分别评价保乳手术的美容效果。结果　共实施保乳手术 18例 ,占同期乳腺癌手术病人的 10 2 %。肿瘤直径 0 3～ 3 0cm ,术后病理分期 0期 4例 ,Ⅰ期 12例 ,Ⅱ期 2例。象限切除 +腋窝淋巴结清扫 (axilarylymphnodedissection ,ALND) 7例 ,区段切除 +腋窝淋巴结清扫 8例 ,单纯区段切除 3例。 18例病人中 ,有 1例放疗后美容效果不理想。全部病例随访未发现复发和转移。结论　乳腺癌保乳手术美容效果良好 ,放疗对乳房外形无明显影响 ,保乳手术加放疗 。Objective To explore the effect of breast-conserving operation for the treatment of early-stage breast cancer. Methods From November 1999 to Octorber 2001, the patients with early-stage breast cancer were treated with breast-conserving surgery followed by radical irradiation according to the patients' will. The cosmetic results and quality of life were analyzed after surgery and radiation. Results In all the patients received operation treatment from 1999 to 2001, eighteen patients were treated with breast-conserving surgery with breast conservation rate of 10.2%, of which 7 cases with quadrantetomy plus axillary lymph node dissection (ALND), 8 cases with lumpectomy plus ALND and 3 cases with lumpectomy. Pathological staging was as follow: 4 cases in stage 0, 12 cases in stage Ⅰ, and 2 cases in stage Ⅱ. All cases were followed-up. The cosmetic results were good in 94%(17/18) and fair in 6%(1/18). All the patients had not local recurrence and distant metastasis. Conclusions Breast-conserving surgery followed by radiation therapy is superior to mastectomy in terms of improving breast cosmesis and quality of life. Postoperative radiation therapy does not affect the cosmetic result.

关 键 词：保乳手术 放射疗法 早期乳腺癌 生活质量 手术指征 

分 类 号：R737.9[医药卫生—肿瘤] R730.55[医药卫生—临床医学]