乳腺癌保乳治疗176例回顾性分析

摘要/Abstract

摘要： 目的探讨乳腺癌保乳治疗的近期疗效及美容效果。方法回顾性分析1996～2007年间176例接受保乳治疗的临床0～IIa期、非乳晕区单发病灶乳腺癌患者的复发、转移和生存情况及乳房外观的评价。全部病例均采用肿瘤局部扩大切除,切缘阴性为保乳治疗的前提;全组均予全乳放疗50Gy加瘤床照射10Gy;浸润性乳腺癌者予辅助化疗;雌孕激素受体阳性者予内分泌治疗。结果随访时间18～162个月,中位随访47.4个月。同侧乳房肿瘤复发7例(3.97%),远处转移8例(4.55%),死亡3例(1.70%),均死于乳腺癌全身转移。乳房外观评价优良、一般和较差分别为106例(62.7%)、61例(36.1%)和2例(1.2%)。其中138例随访满3年,3年总生存率99.28%(137/138),3年无病生存率94.20%(130/138)。结论保乳治疗用于0～IIa期乳腺癌是可行的,严格规范治疗是保乳治疗成功的保证。

关键词: 保乳治疗, 乳腺癌, 外科学

Abstract: Objective To evaluate the prognostic and cosmetic effects of breast-conserving therapy on patients with breast cancer.Methods Data of relapse,metastasis,survival and cosmetic from 176 patients with breast cancer received breast-conserving therapy were analyzed retrospectively.All the patients were in clinical stage 0~IIa,with single lesion in non-areola area.Lumpectomy was adopted with negative margin,followed by 50Gy radiation on whole breast and 10Gy on tumor-bed.Besides,patients carrying invasive breast cancer were given chemotherapy,and those with positive estrogen and/or progesterone receptor were given endocrine therapy.Results All the patients were followed up for a median period of 47.4 months(18～162 months).Ipsilateral breast tumor recurrence(IBTR) was found in 7 cases,distant metastasis was found in 8 cases and 3 of which were dead.The cosmetic results were evaluated according to the criteria of JCRT(Joint Center for Radiation Therapy).169 patients were classed into three grades:good(62.7%),fair(36.1%) and poor(1.2%).138 cases of them were followed up over 3 years.The 3-year overall survival rate was 99.28%,the disease free survival rate was 94.20%.Conclusions Breast-conserving treatment for breast cancer in stage 0~IIa is feasible.The strict and regulated approach is crucial for guaranteeing the success of treatment.

Key words: Breast-conserving therapy, Breast cancer, Surgery, Prognosis

刘庆仪;任洪文;黄小云;李少英;王尊;孙爱静;. 乳腺癌保乳治疗176例回顾性分析[J]. 中国癌症防治杂志, 2010, 2(01): 15-17.

LIU Qing-yi,REN Hong-wen,HUANG Xiao-yun,et al.. Prognostic and cosmetic effects of breast-conserving therapy on 176 patients with breast cancer[J]. Chinese Journal of Oncology Prevention and Treatment, 2010, 2(01): 15-17.

参考文献

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