早期乳腺癌保留乳房的综合治疗

目的：探讨早期乳腺癌最佳治疗方法。方法：自１９９０年４月至１９９５年４月，本院共４８例早期乳腺癌患者接受了保守外科加术后放疗。其中０期１例，Ⅰ期３３例，Ⅱ期１４例。４５例行乳房１／４切除加腋窝淋巴结清扫，３例患者只作肿瘤切除未行腋淋巴结清扫。全部患者均接受围手术期化疗４￣７周（ＣＭＦ或ＣＡＦ方案）。放疗采用４￣６ＭＶ Ｘ线，全乳切线照射，中平面剂量４５Ｇｙ，瘤床用电子束补加１５Ｇｙ，９例腋淋巴结阳

Early Breast Cancer Treated by Conservative Surgery plus Irradiation

Objective Tostudy the local recurrence and prognosis of early breast cancer treated by conservativesurgery combined with irradiation． Methods From April 1990 to April 1995， 48patients with early stage breast cancer were treated by conservative surgery plusirradiation． It consisted of stage 0 one， stage Ⅰ 33 and stage Ⅱ 14． Forty－fivepatients underwent quadrantectomy plus axillary lymph node dissection and the other 3patients had lumpectomy alone． Irradiation was administered by using low tangentialfields with 4～6 MV X－ray． The dose of whole breast was 45Gy／22～23f／4．5W，then 15Gy boost dose was delivered to tumor bed by electron beam． Of 9 patients withpositive axillary lymph node ， 5 were given regional irradiation． All the patientswere given postoperative chemothetrapy for 4－7 weeks． Results All patients werefollowed up for 5 years or more． The 5－year survival rate was 98．9％． The localrecurrence and distant metastasis rates were 6．25％， 4．17％ respectively． Mamma－ryreserved rate was 93．8％． The 5－year survival rate of this group was much betterthan that who re－cieved radical surgery and was similar to the domestic and abroadliteratures． Conclusion For early stage breast cancer， conservative surgerycombined with irradiation is recommended．