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目的探讨复发、转移性乳腺癌的临床特点、治疗方法及个人素质等因素对复发转移的影响。方法采用自制“乳腺癌复发转移因素调查表”对所有复发、转移后入院的病例进行调查分析,调查内容主要有以下三个方面:疾病特征因素、个人素质因素、治疗因素,并对各因素在复发、转移病例的权重进行分析比较。结果通过调查发现,疾病期别较晚(Ⅲ、Ⅳ期)是主要因素;其次为病例类型:浸润性导管癌、病灶位于外侧、以疼痛为主要症状,免疫组化:ER(-),PR(-),C-erbB-2(-)的病例;再次为治疗方法不当和个人性格内向、偏食等。转移时间存在三个高峰期,分别为治疗后2、3、10年。结论乳腺癌复发、转移是由以下原因造成:医生的治疗不规范,疗程不足,方法不当;手术、放疗、化疗顺序颠倒,缺乏统一性;疾病分期较晚,组织分化差,病例类型不好,免疫组化为“三阴”;加之阳性家族史、月经紊乱史、性格内向、偏食等。因此,需针对上述因素采取积极有效地处理措施,才能降低复发及转移率。
Objective To investigate the clinical characteristics, treatment and personal qualities of recurrent and metastatic breast cancer on the recurrence and metastasis. Methods The self-made “Breast Cancer Recurrence and Metastasis Questionnaire” was used to investigate and analyze all cases of recurrent and metastatic patients admitted to hospital. The contents of the investigation mainly include the following three aspects: disease characteristic factors, individual quality factors and treatment factors, Factors in the recurrence, the weight of the transfer case analysis and comparison. Results The survey found that the disease stage was late (stage Ⅲ and Ⅳ) was the main factor, followed by the case type: invasive ductal carcinoma with the lesion located on the lateral side and the pain as the main symptom. Immunohistochemistry: ER (-), PR (-), C-erbB-2 (-) cases; again for improper treatment and personal introverted, partial eclipse and so on. There are three peak transfer time, respectively, 2, 3, 10 years after treatment. Conclusions The recurrence and metastasis of breast cancer are caused by the following reasons: The doctor’s treatment is not standardized, the course of treatment is inadequate, the method is improper; surgery, radiotherapy and chemotherapy are in reverse order, lack of unity; late stage of disease, poor tissue differentiation, Immunohistochemistry as “Sanyin ”; combined with positive family history, history of menstrual disorders, introverted, partial eclipse and so on. Therefore, the above factors need to be taken actively and effectively to reduce the recurrence and metastasis rate.