新辅助化疗联合保乳手术治疗乳腺癌安全性临床探讨

目的探讨研究新辅助化疗联合保乳手术治疗乳腺癌的临床安全性。方法选取同时期的62例早期乳腺癌患者,随机分为观察组和对照组,观察组采用新辅助化疗联合保乳手术治疗;手术方式为象限切除或肿块局部广泛切除联合腋窝淋巴结清除。治疗组采用常规根治性切除术,术后行辅助化疗,方案同观察组。比较两组患者手术持续时间、术中出血量、手术并发症发生率、住院天数、患者满意率等指标。术后对患者局部复发、远处转移及乳房外形情况进行随访观察。结果观察组采用新辅助化疗2～4个疗程后,手术前肿瘤病灶临床完全缓解(CR)9例,部分缓解(PR)37例。术后病理学检查癌细胞均有不同程度的变性、坏死;乳腺癌治疗后2a随访,观察组局部复发率为9.6%(3/31),对照组为6.4%(2/31),两组比较无统计学意义(P>0.05);观察组远处转移率为12.9%(4/31),与对照组16.1%(5/31),比较无统计学意义(P>0.05)。结论新辅助化疗联合保乳手术治疗Ⅱ期乳腺癌是安全的,与传统的乳腺癌根治性术相比,疗效无明显差别。新辅助化疗联合保乳手术治疗Ⅱ期乳腺癌具有创伤小、功能恢复快、不良反应小等优点。

Investigation to clinical safety for the neoadjuvant chemotherapy combined with breast-conserving treatment with breast cancer

Objective To investigate the clinical safety for the neoadjuvant chemotherapy combined with breast-conserving treatment with breast cancer.Methods 62 patients with early breast cancer in the same period were randomly divided into observation group and control group.The observation group were treated with neoadjuvant chemotherapy and breast conserving surgery.Surgical approach included the quadrant resection or wide excision of lump plus axillary lymph node dissection.Treatment group used a conventional radical resection and postoperative adjuvant chemotherapy.Duration,blood loss,surgical complication rates,length of stay,patient satisfaction rate and other indicators were observed.Local recurrence,distant metastasis and shapes of breasts were followed-up after surgery.Results The observation group was treated with neoadjuvant chemotherapy of two to four courses.9 patients had clinical complete remission(CR) and 37 patients had partial remission(PR) before surgery.Cancer cells have different levels of degeneration and necrosis with pathological examination after surgery.All patients with breast cancer were followed-up after two years.The local recurrence rate was 9.6%(3/31) in the observation group and 6.4%(2/31) in the control group.It was not statistically significant(P>0.05).The distant metastasis rate was 12.9%(4/31) in the observation group and 16.1%(5/31) in the control group.There was no significant difference(P>0.05).Conclusion Neoadjuvant chemotherapy and breast-conserving surgery for Ⅱ stage breast cancer is safe.There was no significant difference in efficacy compared to radical surgery with breast cancer.Neoadjuvant chemotherapy and breast-conserving surgery with Ⅱ stage breast cancer have trauma,quick recovery of function,side effects and other advantages.