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目的 探讨老年女性乳腺癌的最佳治疗方法及影响预后的因素。方法 回顾性分析了 1985年 10月至 1995年 10月收治的老年女性乳腺癌的临床资料。结果 在 12 7例患者中 ,114例手术治疗 ,其中 95例在全麻或硬膜外麻醉下进行了乳腺癌根治、改良根治及单纯切除术 ,19例行肿瘤局部切除术。 9例单纯放疗 ,4例单纯化疗。 12例于术后 (局部切除 9例 ,单纯切除 3例 ) 6个月至 5年时局部复发 ,3 6例在随访 4个月至 6年时出现肺、肝、骨及脑部转移 ,3 5例在随访 8个月至 5年 7个月时死于本病 ,9例死于其它疾病。经Kaplan Meier生存率计算 ,其总的 3、5、10年生存率分别为 93 .7%、5 9.3 %及 5 8.1%。 结论 老年女性乳腺癌的临床治疗应以外科手术为主 ,并应多选择改良根治的手术方式。淋巴结转移、病理类型及肿瘤大小是影响预后的显著因素 (P <0 .0 5 )。
Objective To explore the best treatment of breast cancer in elderly women and the factors that influence the prognosis. Methods The clinical data of elderly women with breast cancer admitted from October 1985 to October 1995 were retrospectively analyzed. RESULTS Of the 12 7 patients, 114 underwent surgical treatment, 95 of whom underwent radical or modified radical mastectomy under general or epidural anesthesia, and 19 underwent local tumor resection. Nine cases received radiotherapy alone and four received chemotherapy alone. Twelve patients had local recurrence 6 months to 5 years after surgery (nine local resections and 3 resections alone). 36 patients had lung, liver, bone, and brain metastases at 4 months to 6 years of follow-up. 3 Five patients died of the disease at follow-up from 8 months to 5 years and 7 months, and 9 patients died of other diseases. According to the Kaplan Meier survival rate, the overall 3-, 5-, and 10-year survival rates were 93.7%, 59.3%, and 58.1%, respectively. Conclusion The clinical treatment of elderly women with breast cancer should be based on surgery, and should choose more modified radical surgery. Lymph node metastasis, pathological type and tumor size were significant factors that affected the prognosis (P < 0.05).