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目的:探讨乳腺癌保乳手术加综合治疗的手术适应证、治疗方法和疗效。方法:对31例Ⅰ~Ⅱb期乳腺癌施行保乳手术加术后放疗、化疗及内分泌治疗等综合治疗(保乳组),并与同期施行改良根治术加综合治疗的34例Ⅰ~Ⅱb期乳腺癌(对照组)进行对比,两者术后均随访0.6~12年,平均3.8年。结果:保乳组31例双侧乳房乳头基本对称、外形丰满、外观优良。保乳组、对照组的平均手术时间分别为(162.6±26.7)和(192.6±21.0)min,术中平均出血量分别为(263.0±29.6)和(398±53)mL,手术并发症发生率分别为16.1%和36.3%,保乳组均优于对照组(均P<0.05)。保乳组3、5和10年期生存率分别是95%、81.8%和80%,总的局部复发率是6.4%;对照组3、5、10年期生存率分别是95.6%、84.6%、83.3%,总的局部复发率是5.8%,两组生存率和复发率比较差异无显著性(均P>0.05)。结论:临床早期乳腺癌采用保乳手术加综合治疗可以取得满意的临床疗效,早期乳腺癌可以行保乳治疗。
Objective: To investigate breast conservative breast-conserving surgery plus comprehensive indications, treatment methods and efficacy. Methods: 31 cases of breast cancer Ⅰ ~ Ⅱb breast-conserving surgery combined with postoperative radiotherapy, chemotherapy and endocrine therapy and other comprehensive treatment (breast protection group), and with the implementation of modified radical mastectomy and combined treatment of 34 cases of Ⅰ ~ Ⅱ b Breast cancer (control group) were compared, both were followed up for 0.6 to 12 years, an average of 3.8 years. Results: Breast-conserving group 31 cases of bilateral breast nipple basically symmetrical, plump appearance, excellent appearance. The average operation time of breast-conserving group and control group were (162.6 ± 26.7) and (192.6 ± 21.0) min, respectively. The mean intraoperative blood loss were (263.0 ± 29.6) and (398 ± 53) mL, respectively. The incidence of operative complication Respectively, 16.1% and 36.3%, breast-conserving group were better than the control group (P <0.05). The 3, 5 and 10-year survival rates in breastfeeding group were 95%, 81.8% and 80% respectively, and the total local recurrence rate was 6.4%. The 3-, 5- and 10-year survival rates in control group were 95.6% and 84.6% , 83.3% respectively. The total local recurrence rate was 5.8%. There was no significant difference between the two groups in survival rate and recurrence rate (all P> 0.05). Conclusion: Early clinical breast-conserving surgery combined with comprehensive treatment can achieve satisfactory clinical efficacy, early breast cancer can breast-conserving treatment.