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目的 进一步评价保留乳头改良根治术治疗Ⅰ、Ⅱ期乳腺癌的疗效。方法 1995年 3月至 2 0 0 2年 10月共施行该手术 38例 ,其中Ⅰ期 2 2例 ,Ⅱ期 16例 ,35例符合作者制订的手术适应证 ,3例略超出手术适应证。结果 38例病人中 ,术后发生乳头表皮部分坏死 1例 ,1个月后乳头皮肤痂下愈合 ;皮下积液 3例 ,经穿刺抽液治愈 ;34例切口甲级愈合 ,顺利出院。全部病例乳头基底部切线病理检查均无癌浸润。术后 38例全部随访 ,最长随访时间 93个月 ,中位随访时间 5 9个月。 1例肿瘤直径为 4cm者术后 49个月发生乳头基底部复发 ,行乳头乳晕复合体切除后随访 2 6个月无瘤生存。其余 37例病人均无局部复发和远处转移。结论 保留乳头改良根治术可作为Ⅰ、Ⅱ期乳腺癌手术治疗的选择术式。
Objective To evaluate the curative effect of modified radical mastectomy for the treatment of stage Ⅰ and Ⅱ breast cancer. Methods From March 1995 to October 2002, 38 cases were performed. Among them, 22 cases were stage Ⅰ and 16 cases were stage Ⅱ, 35 cases were in accordance with the surgical indications developed by the authors, and 3 cases were slightly beyond the indications for operation. Results In 38 patients, partial necrosis of the papillary epidermis occurred in 1 case and healed after 1 month. The subcutaneous effusion was cured in 3 cases. The wounds were cured by puncture and drainage. All cases of tactile papillae tactile pathological examination without cancer infiltration. All 38 patients were followed up for a maximum of 93 months, with a median follow-up of 59 months. One patient with a tumor diameter of 4 cm had a recurrence of papillary base at 49 months after operation, and had a tumor-free survival at a follow-up of 26 months after excision of the nipple-areola complex. The remaining 37 patients no local recurrence and distant metastasis. Conclusion Modified radical mastectomy can be used as a surgeries for surgical treatment of stage Ⅰ and Ⅱ breast cancer.