论文部分内容阅读
目的 :探讨乳腺癌保乳手术的合理适应证。方法 :回顾性分析 10 4例乳腺癌保乳手术患者的年龄、肿瘤大小、肿瘤部位、腋淋巴结状态、临床分期、病理类型等因素在保乳手术决策中的价值。结果 :本组患者 10 0例得到随访 ,失访 4例 ,随访率96 .4 % ;随访时间 1～ 5 6个月 ,中位随访时间 4 2个月。其中 1例于手术后 2 6个月发现原发性子宫内膜癌 ,4 9个月后死亡 ;1例 12个月后同侧腋窝复发改行改良根治术 ;1例发现同侧锁骨上淋巴结转移行放疗 ;1例发现对侧原发性乳房癌行根治性手术 (原保乳侧为导管浸润癌 ,对侧再发为导管内癌 ) ;1例患乳再发纤维腺瘤而做局部切除术。结论 :保乳手术将逐渐成为I、II期乳腺癌患者的主流手术 ,甚至部分IIIA期患者在新辅助化疗后可以获得保乳机会 ,保乳手术的适应证有扩大的趋势
Objective: To investigate the reasonable indications of breast conserving surgery. Methods: The value of age, tumor size, tumor location, axillary lymph node status, clinical stage and pathological type in 104 breast conserving surgery patients were retrospectively analyzed. Results: A total of 100 cases were followed up and 4 cases were lost to follow-up. The follow-up rate was 96.4%. The follow-up time ranged from 1 to 56 months. The median follow-up time was 42 months. One case had primary endometrial cancer at 26 months after operation, and died after 49 months. One case had ipsilateral axillary recurrence after 12 months and modified radical mastectomy. One case found ipsilateral supraclavicular lymph node metastasis 1 case of radical surgery of the contralateral primary breast cancer (the original conservative side of ductal carcinoma, contralateral recurrence of intraductal carcinoma); 1 case of recurrent breast fibroadenoma and local excision Surgery. Conclusion: Breast-conserving surgery will gradually become the mainstream surgery for patients with stage I and II breast cancer. Even some patients in stage IIIA may have breast-conserving opportunities after neoadjuvant chemotherapy, and the indications for breast-conserving surgery have an expanding trend