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目的通过老年人乳腺癌保乳治疗和改良根治术的比较,探讨保乳治疗老年人乳腺癌的疗效。方法回顾分析2003年1月-2006年3月于我院接受保乳手术治疗的60例老年乳腺癌患者临床资料,其中I期41例,Ⅱ期19例(ⅡA期16例、ⅡB期3例)。手术方式为肿瘤广泛切除术或象限切除术,联合腋窝淋巴结清扫。术后常规行辅助放疗、化疗和内分泌治疗。并与同期60例行改良根治术常规综合治疗的老年乳腺癌患者(I期32例、ⅡA期16例、ⅡB期12例)做临床疗效对比研究。结果经过术后2年的随访,保乳手术组无局部复发及远处转移,全部生存。改良根治术组局部复发率为0(0/60),远处转移率1.67%(1/60),手术至远处转移时间16个月,转移部位为左锁骨上淋巴结。两个组的近期疗效差异无统计学意义(P>0.05)。结论老年人乳腺癌保乳治疗与仿根治术相比较能取得满意的疗效。规范化的切除和术后化疗、放疗、内分泌治疗等综合治疗是保乳治疗成功的关键。保乳治疗是老年乳腺癌理想的治疗方法。
Objective To compare breast-conserving therapy with modified radical mastectomy in elderly patients and explore the effect of breast-conserving treatment on breast cancer in the elderly. Methods The clinical data of 60 elderly patients with breast cancer undergoing breast-conserving surgery in our hospital from January 2003 to March 2006 were analyzed retrospectively, including 41 cases of stage I and 19 cases of stage II (16 cases in stage IIA and 3 cases in stage IIB) ). Surgery for extensive tumor resection or quadrant resection, combined with axillary lymph node dissection. Routine postoperative adjuvant radiotherapy, chemotherapy and endocrine therapy. The clinical efficacy of 60 patients with advanced breast cancer (32 cases in stage I, 16 cases in stage IIA and 12 cases in stage IIB) were compared with 60 cases of conventional breast cancer treated by modified radical mastectomy in the same period. Results After 2 years of follow-up, breast-conserving surgery group had no local recurrence and distant metastasis and all survived. In the modified radical mastectomy group, the local recurrence rate was 0 (0/60), the distant metastasis rate was 1.67% (1/60), the operation was distant metastasis for 16 months, and the metastatic site was the left supraclavicular lymph node. There was no significant difference in the short term efficacy between the two groups (P> 0.05). Conclusion Elderly breast-conserving therapy can achieve satisfactory results compared with radical mastectomy. Normalized resection and postoperative chemotherapy, radiotherapy, endocrine therapy and other comprehensive treatment is the key to the success of breast-conserving treatment. Breast-conserving treatment is an ideal treatment for elderly breast cancer.