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自80年代中后期开始,许多医院相继开展了乳癌保留乳房治疗,现在有逐渐增加的趋势。但由于历史尚短,有许多问题尚有待探讨。 1 适应证欧美国家基本上将Ⅰ、Ⅱ期乳癌作为保留乳房治疗的对象。但日本尚较为保守,虽然目前尚无统一标准,不同单位在适应证选择上亦存在差异,但多是Ⅰ期乳癌或肿瘤直径在2～3cm以下者,肿瘤距乳头应在3～5cm以上。东京女子医科大学附属第二病院外科自1987年开始,开展了乳癌保留乳房治疗,具体适应证是:(1)肿瘤直径不超过2.5cm(不考虑肿瘤的所在部位),(2)无淋巴结转移或者有转移但少于3个,包括原位癌(Tis);(3)除外广泛钙化、多发癌、腋窝淋巴结转移超过4个(n,β)或者有胸廓内淋巴结转移者,以及显著的淋巴管浸润者。
Since the middle and late 1980s, many hospitals have successively conducted breast cancer treatment, and there is a gradual increase. However, due to the short history, many issues remain to be explored. 1 Indications Europe and the United States basically use stage I and stage II breast cancer as targets for breast cancer treatment. However, Japan is still relatively conservative, although there is no uniform standard, different units in the selection of indications there are differences, but most are stage I breast cancer or tumor diameter is below 2 ~ 3cm, the tumor from the nipple should be 3 ~ 5cm or more. The Second Affiliated Hospital of Tokyo Women’s Medical University began surgery in 1987 to carry out breast cancer therapy. The specific indications are: (1) The tumor diameter does not exceed 2.5cm (without considering the location of the tumor), and (2) No lymph node metastasis Or metastasis but less than 3, including carcinoma in situ (Tis); (3) Except for extensive calcification, multiple cancers, axillary lymph node metastases more than 4 (n, β) or with intrathoracic lymph node metastases, and significant lymph nodes Tube infiltrators.