乳腺癌术后局部复发因素的探讨

目的探讨乳腺癌术后局部复发的影响因素,以便更有效地预防乳腺癌术后局部复发.方法对1994年1月至2002年12月我院乳腺科女性原发乳腺癌522例患者进行分析,观察年龄、手术方式、肿瘤临床分期、病理组织学类型、腋窝淋巴结转移数目、辅助化疗情况、雌激素受体水平等因素对术后局部复发的影响.结果 522例患者中,局部复发38例,复发率7.3%.其中年龄、手术方式对局部复发无显著影响;临床分期、病理组织学类型、腋窝淋巴结转移数目、化疗完成情况是影响术后局部复发的重要因素.雌激素受体测定双阳性或双阴性对局部复发有直接影响.结论早期诊断是防止乳腺癌复发转移的有效途径.原发肿瘤大小、病理组织学类型、腋淋巴结阳性数是影响局部复发的主要因素.严格掌握保乳手术指征,是减少复发的关键.规范化疗是防止局部复发的重要因素.雌孕激素受体水平是估测局部复发的参考指标.内分泌治疗,可减少局部复发.早期诊断、规范治疗是防止乳腺癌局部复发和转移的有效措施.

Study on postoperative local recurrence of breast cancer

Objective To study the main determinants of postoperative local recurrence of breast cancer so as to prevent the postoperative local recurrence.Method 522 patients with primary breast cancer between 1994 and 2002 were analyzed retrospectively to observe the influence of age,procedure,clinical stage,histopathological type,number of axillary lymph node involvement,with or without auxiliary chemotherapy and status of estrogen receptor on postoperative local recurrence.Results Of the 522 patients,38 had local recurrence,with rate of 7.3%.The age and procedure had no influence on local recurrence,while clinical stage,histopathological type,number of axillary lymph node involvement,auxiliary chemotherapy were the main factors influencing local recurrence.The double-negative or double-positive result of estrogen receptor examination had direct influence on local recurrence.Conclusions The early diagnosis is an effective way to prevent breast cancer from recurrence.Tumor size,histopathological type,number of positive axillary lymph nodes are the main factors influencing local recurrence.Strict control of the indications of breast-preservation operation is the key to reduce the local recurrence.Standardization of chemotherapy is the important factor for preventing local recurrence.Endocrinetherapy can decrease local recurrence.The early diagnosis and standardization therapy are the effective measures to prevent breast cancer from local recurrence and metastasis.