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近日,外科肿瘤学会(SSO)、美国放射肿瘤学会(ASTRO)共同制定乳腺癌手术切缘新指南。指南规定,在多学科综合治疗时代,Ⅰ、Ⅱ期浸润性乳腺癌保乳手术采用“切缘无肿瘤累及”作为浸润性癌的安全手术切缘标准;并指出,常规临床实践中采用比无瘤切缘更广泛的切缘或不可取。切缘问题一直是乳腺外科医生讨论最多的话题之一,但对可接受的切缘宽度存在很大争议。在基于安全(最低的术后局部复发率)的情况下,获得最完美的结果(术后乳腺外形的完美)。外科医生既不能为了安全或担心再次手术的费时、费力,而有意识地扩大切缘;也不能为了追求外形或降低再次手术率,而有意识的假定有限切缘
Recently, the Society for Surgical Oncology (SSO) and the American Society of Radiation Oncology (ASTRO) jointly developed a new guideline on surgical margin of breast cancer. Guide provides that in the era of multidisciplinary treatment, Ⅰ, Ⅱ invasive breast cancer breast conserving surgery using “marginal tumor-free ” as a safe margin of invasive surgical margins standards; and pointed out that the use of conventional clinical practice It is more desirable or less desirable than the margin of non-tumor margin. Marginal problems have been one of the most discussed topics for breast surgeons, but there is considerable controversy over the acceptable margin width. In the case of safety-based (lowest postoperative local recurrence), the most perfect result (perfection of breast shape after surgery) is obtained. The surgeon can not consciously increase the margin of excision for the sake of safety or fear of the time-consuming and laborious operation of re-operation; nor can the conscious assumption of a limited margin in pursuit of appearance or reduction of re-operation rate