早期乳腺癌保乳术加辅助治疗临床疗效分析

[目的]分析早期乳腺癌保乳术加辅助治疗临床疗效。[方法]回顾性分析某院自1983～2006年收治的乳腺癌患者762例,其中需进行保乳术的患者422例,随机选取同期收治的340例行传统改良根治术的患者,两组临床病例资料均保存完整,对两组临床资料进行对照分析。[结果]两组术后乳房美容效果保乳术组与改良根治术组总体疗效比较,差异有统计学意义(P﹤0.05)。保乳术组与改良根治术组比较,在局部复发、远处转移及死亡发生率比较,差异无统计学意义(P﹥0.05)。[结论]早期乳腺癌保乳治疗疗效确切安全。辅助治疗可以降低局部复发率,提高生存率,在保乳术后占据重要地位。     

两种手术方式治疗早期乳腺癌的临床效果观察

目的探讨改良根治术与保乳术在早期乳腺癌手术治疗中的临床效果及安全性。方法选取2012年3月-2013年3月该院收治的80例早期乳腺癌女性患者为研究对象,根据手术方式分为改良组(改良根治术)和保乳组(保乳术),各40例,对比两组患者手术情况及术后美容效果,并进行为期3年的随访,对比两组患者并发症发生率、生存率、局部复发及远处转移情况,并应用QOL-100量表中心理状态评定量表对患者治疗前后的心理状态进行评估。结果与改良组对比,保乳组患者术中出血量显著减少,切口长度、手术时间及住院时间显著缩短(P0.05);保乳组患者术后乳房美容优良率(85.00%)显著高于改良组(62.50%),差异有统计学意义(P0.05);两组患者的并发症、局部复发、远处转移、腋淋巴结复发发生率及生存率比较,差异均无统计学意义(P0.05);与术前比较,两组患者的心理状态在术后均显著改善,差异有统计学意义(P0.05),且保乳组较改良组改善更显著(P0.05)。结论改良根治术与保乳术对早期乳腺癌治疗的远期效果相当,但保乳术的手术情况及术后乳房美容效果均优于改良根治术。     

早期乳腺癌保乳术与改良根治术治疗乳腺癌的比较研究

目的:了解乳腺癌保乳术和改良根治术的具体方法,比较早期保乳术和改良根治术对乳腺癌的治疗效果。方法:将70例早期乳腺癌患者根据患者意愿随机分为两组,保乳组35例使用保乳术进行治疗,改良组35例,使用改良根治术进行治疗,比较两组疗效。结果:两组生存率、局部复发率、腋窝淋巴结复发率及远处转移率比较无统计学差异(P>0.05);但保乳组在生活质量及美容效果上显著好于改良根治组(P<0.01)。结论:保乳术和改良根治术对早期乳腺癌的治疗效果都比较显著,但保乳术对改善患者生存质量方面明显好于改良根治术,应当在临床过程中结合患者意愿选择使用。     

改良根治术与保乳手术治疗早期乳腺癌的疗效

目的研究改良根治术和保乳手术治疗早期乳腺癌的近远期疗效差异。方法在2009年1月-2012年1月来云浮市人民医院被确诊为早期乳腺癌患者中选出50例为研究对象,根据手术方法不同分为改良根治术组和保乳手术组各25例,改良根治术组给予改良根治术治疗,保乳手术组给予保乳手术治疗,对比两组患者的手术治疗效果。结果手术时间、手术恢复时间、术中出血量、切口长度及并发症发生率,保乳手术组均优于改良根治术组,差异有统计学意义(P0.05);在术后1年以及术后5年的生存率、局部复发率、远处转移率、腋窝淋巴结复发率远期疗效指标上两组差异无统计学意义(P0.05)。结论早期乳腺癌患者的应用保乳手术和改良根治性手术远期疗效相当,而保乳手术的近期疗效更好,手术创伤较小,且满足患者对乳房外形美观的需求,更容易为患者所接受,值得临床推广。     

早期乳腺癌保乳外科治疗的近期疗效观察

目的评价早期乳腺癌保留乳房外科治疗的效果。方法总结我院2002年4月～2007年6月期间36例接受保乳治疗和136例接受改良根治术早期乳腺癌患者的临床资料,对比淋巴结清扫的数目、术后并发症、住院天数、美容效果和复发、转移情况。结果淋巴结清扫数目:保乳手术组(16.0±2.1)个/例,改良根治术组检出淋巴结(15.2±1.3)个/例(P>0.05);平均住院天数:保乳组(10.1±0.8)天,改良根治组(14.6±0.1)天(P<0.01)。术后并发症:保乳组无皮瓣坏死、皮下积液、患肢水肿和功能障碍;改良根治组皮瓣坏死8例(5.9%),积液12例(8.8%),患肢水肿和功能障碍6例(4.4%)。随访期内复发率和转移率:保乳组无转移和复发;改良根治组复发9例(6.6%)转移12例(8.8%)。保乳术乳房外观良好,优良率100%。结论保乳治疗早期术后疗效满意,同时具有良好的美容效果。     

乳腺癌保乳术联合术后放疗治疗早期乳腺癌的临床效果观察

目的探讨乳腺癌保乳术联合术后放疗治疗早期乳腺癌的临床效果。方法选取东港市某医院收治的112例早期乳腺癌患者,采取随机数字表法将患者分为对照组(n=55)和观察组(n=57),对照组患者予以乳腺癌改良根治术治疗,观察组患者予以乳腺癌保乳术联合术后放疗治疗,2组患者术后均予以常规的CMF化疗方案化疗,比较2组患者的疗效。结果观察组患者的术中出血量少于对照组,手术时间、住院天数短于对照组,术后并发症发生率低于对照组,乳房美容总有效率高于对照组,SF-36量表各维度评分均高于对照组,差异均有统计学意义(P0.05)。结论与改良根治术相比,应用乳腺癌保乳术联合术后放疗治疗早期乳腺癌具有更多的优点,值得临床推广。     

早期乳腺癌患者保乳根治术的护理

目的探讨早期乳腺癌患者保乳根治术的护理观察.方法采用保乳根治术52例、改良根治术50例,进行回顾性分析,针对术后患者不适及并发症进行对比观察.结果保乳根治术组患者术后疼痛、伤口延期愈合、伤口皮瓣坏死、抑郁、上肢肿胀等与改良根治术组相比,有显著性差异(P＜0.05);术后患者胸闷不适、对乳房保持美观满意率,亦有显著性差异(P＜0.05).结论保乳手术对治疗早期乳腺癌具有良好的治疗和美容效果.耐心地解释及疏导,精心的护理是患者顺利完成手术治疗的关键.     

乳腺癌改良根治术与保乳术对乳腺癌患者存活质量、社会适应性及心理状态的影响

目的 分析乳腺癌改良根治术与保乳术对乳腺癌患者生存质量、社会适应性及心理状态的影响。 方法 回顾性分析2009年6月-2012年5月接受治疗的62例乳腺癌患者的临床资料,按治疗方式分为保乳术组(n=34)与根治术组(n=28),2组术后均完成3年随访。比较2组乳房美观效果,记录肿瘤复发、转移情况。 结果 ①保乳术组乳房恢复优良率为94.12%,明显高于根治术组的71.43%,2组对比差异有统计学意义(χ²=5.843,P<0.05);②术后,保乳术组生理状况、社会状况、情感状况、功能状况、附加关注等维度评分均显著上升,分别为(19.66±3.44)分、(18.78±2.98)分、(15.58±2.16)分、(20.34±2.97)分、(22.44±5.26)分,且上升幅度均高于根治术组(P<0.05);③术后,保乳术组心理弹性、控制倾向、人际适应性、心理能量等维度评分均明显上升,分别为(49.66±2.74)分、(45.59±3.36)分、(48.89±4.26)分、(48.87±1.26)分,上升幅度均高于根治术组(P<0.05);④术后,保乳术组HAMA、HRSD量表评分均显著降低至(12.68±5.44)分、(11.41±4.98)分,降低幅度均高于根治术组(P<0.05);⑤保乳术组复发、转移率略高于根治术组,术后生存率略低于根治术组,但对比差异无统计学意义(P>0.05)。 结论 在乳腺癌患者的临床治疗中采用保乳术,与改良根治术效果相当,但可提高乳房美观度,改善患者心理状态,提高其社会适应度,优化生活质量。     

早期乳腺癌保乳手术与改良根治手术的临床效果对比

目的:对早期乳腺癌患者分别进行保乳手术与改良根治手术,对比其临床效果。方法:选取2017年1月至2017年12月于聊城市东昌府区中医院收治的60例早期乳腺癌患者,分为保乳手术组(A组)和改良根治手术组(B组),比较其两组患者的手术时间、术中出血量、住院时间以及生存率,局部复发率,腋淋巴结复发率和远处转移率。结果:B组的生存率比A组高(93.3%vs70.0%),其腋淋巴结复发率比A组低(6.7%vs20.0%),具有显著性差异(P<0.05);A组和B组患者的局部复发率(16.7%vs10.0%)以及远处转移率(10.0%vs13.3%)并无统计学差异(P>0.05)。结论:行改良根治术治疗早期乳腺癌的术中效果略差于保乳手术,但是前者的远期效果更佳。     

保乳手术与改良根治术治疗Ⅰ、Ⅱ期乳腺癌的近期疗效分析

目的探讨保乳手术与改良根治术治疗Ⅰ、Ⅱ期乳腺癌的近期疗效。方法Ⅰ、Ⅱ期乳腺癌女性患者120例根据手术治疗方法的不同分为治疗组60例与对照组60例,治疗组采用保乳手术治疗,对照组采用改良根治手术。所有患者手术治疗结束后采用三维适形治疗计划。结果治疗组的手术时间、术中出血量、总引流量和腋窝淋巴结清扫时间明显少于对照组（P〈0.05）。治疗组治疗后乳房美容优良率为90.0%,对照组为75.0%,组间比较,差异有统计学意义（P〈0.05）。治疗组治疗后的生理状况、社会/家庭状况、情感状况和功能状况评分明显高于对照组,差异有统计学意义（P〈0.05）。随访1年,治疗组的局部复发率与远处转移与对照组比较,差异无统计学意义（P〉0.05）。结论相对于改良根治术,保乳手术治疗Ⅰ、Ⅱ期乳腺癌能减少创伤,提高乳房美容满意度,改善乳房功能,且安全性好,值得推广应用。     

Impact of benign breast biopsy upon breast self-examination

Current American Cancer Society guidelines recommend monthly performance of breast self-examination (BSE) for women over 20 years of age. While the experience of a benign breast biopsy can result in elevated levels of distress, the impact of benign biopsy upon breast cancer (BC) screening behavior is not well known. The present study examined frequency of BSE practice in 102 women after benign breast biopsy (biopsy group). Telephone interviews were completed a mean of 21 days (initial interview) and 8 months after biopsy (follow-up interview). A healthy comparison (HC) group of women (n = 76) without a history of breast biopsy completed an initial interview only. Information regarding distress, dispositional characteristics, BC screening-related attitudes and behaviors, and subjective and objective risk for BC was collected. Results indicated that the biopsy and HC groups did not differ in typical (i.e., prebiopsy) practice of BSE. However, practice of BSE changed after biopsy with a general trend toward a decrease in BSE frequency. Only 8% of women in the biopsy group reported appropriate (once per month) practice of BSE at the 8-month Follow-up while 28% reported appropriate practice at the initial interview. Decreases in BSE performance after biopsy were characteristic of younger women, women who lacked confidence in the ability to perform BSE correctly, and women whose biopsy was preceded by discovery of a breast lump or abnormality during BSE. Results suggest the potential value of a psychoeducational intervention after biopsy to enhance appropriate performance of BSE.     

乳腺不可触及肿物超声引导下定位的分析

目的:探讨乳腺不可触及肿物超声引导下定位的临床价值。方法:对2008年该院收治住院100例乳腺不可触及肿物的患者进行超声引导下导丝定位,并切除。结合手术后病理组织学诊断进行分析。结果:二维图像上乳腺癌在形态、边界、周围组织结构、内部回声、声影、微钙化等均有其特征性改变;彩色多普勒上乳腺癌的血流信号以2～3级为主。超声引导下定位切除的131个变中,良性病变122个,其中硬化性腺病14个,硬化性腺病伴纤维瘤形成69个,导管内乳头状瘤8个,纤维瘤24个,腺肌上皮瘤2个,腺病单纯囊肿局部性炎性3个,积乳囊肿2个;恶性病变9个,其中囊肿伴淋巴浸润癌1个,导管原位癌2个,浸润性导管癌4个,浸润性小叶癌2个。结论:乳腺不可触及肿物的超声引导下导丝定位是一种安全的方法,有助于提高乳腺良、恶性肿瘤的诊断与鉴别诊断,为临床诊断提供有价值依据。     

The role of clinical breast examination and breast self-examination

The efficacy of screening by clinical breast examination (CBE) and/or breast self-examination (BSE) is reviewed using indirect evidence from randomized breast screening trials and that from observational studies. In countries where breast cancer is diagnosed at an advanced stage, screening by CBE with the teaching of BSE as an integral component will probably be effective in reducing breast cancer mortality. However, in technically advanced countries where adequate treatment is given, no screening modality is likely to be sufficiently beneficial to outweigh the harms of screening, especially false positives and over-diagnosis.     

乳腺癌保乳治疗中的相关问题

目的:探讨早期乳腺癌保乳治疗的相关问题。方法:通过对51例乳腺癌保乳治疗病例的回顾性分析,总结其综合治疗的经验体会。同时对乳腺癌保乳治疗中病人的生活质量、经济承受能力、综合治疗的顺序等问题予以综合性分析。结果:除1例患者外,所有乳腺癌保乳手术病例均实施规范化治疗,中位随访时间12.7个月,局部复发率0.02%。结论:乳腺癌保乳治疗相关问题的处理方法是可行的。     

Family history of breast cancer, mammographic features of breast tissue, and breast cancer risk.

I reexamined the relations of family history of breast cancer in first-degree relatives, mammographic features of breast tissue, and breast cancer risk, using data from three case-control studies. Subjects included 1,047 cases with newly diagnosed breast cancer and 2,329 controls. Family history of breast cancer showed only a weak relation to mammographic features. In addition, while family history and mammographic features were each related to breast cancer risk, associations of these two factors with risk appeared additive. In contrast to previous reports, these data suggest that, to a large extent, family history and mammographic features have independent effects on breast cancer development.     

Effects of public education about breast cancer and breast self-examination

In a field experiment severity of and susceptibility to breast cancer were varied in four different persuasive messages about breast cancer and breast self-examination (BSE). The purpose of this study was to find out whether such health messages in a real-life setting had an effect on knowledge about symptoms, attitudes and behavior relating to BSE. The second goal of this study was to investigate whether fear, aroused by these persuasive communications, had a significant role in influencing the recommended behavior (BSE). In spite of a successful manipulation of seriousness and susceptibility no differences for the dependent variables could be established between the experimental groups after one month. However, differences were found by comparing the experimental groups with the no health message group. After reading the pamphlet (no matter which of the four) women showed greater intention to perform BSE regularly. This could be attributed to a higher estimation of the chance of recovery through early detection of lumps (efficacy) after reading the pamphlet. The health messages also appeared to have a positive influence on compliance with recommended behavior: women examined their breasts more in the prescribed way. An inhibiting effect of fear on behavior (which is sometimes theoretically suggested) was not found. The effects of the pamphlet that were established are formed in a more informational, cognitive way.     

Special considerations in breast cancer treatment of an augmented breast

Breast augmentation surgery involving the use of implants has been one of the most popular plastic surgical procedures for decades. As the multi-million female population who received breast implants ages, the risk of cancer is increasing rapidly, therefore the incidence of malignant disease in association with breast implants will increase as well. Although there is no relationship between tumor development and implants, these cases require special considerations in diagnostics, therapy and follow-up methods. Appropriate multidisciplinary treatment of tumors in augmented breasts corresponding with modern oncoplastic principles can only be accomplished based on adequate oncological, breast and plastic surgical knowledge. Supposing a possible increase of this condition in Hungary, too, authors provide a wide review of the literature on the special oncological and esthetic considerations, for the first time in Hungarian language.     

乳腺癌浸润相关因素分析及其在保乳手术中的应用

目的 探讨乳腺癌保乳手术距肿瘤边缘最佳的切除范围及肿瘤浸润相关因素。方法 对100例乳腺癌患者行肿瘤切除的标本分别距肿瘤边缘0．5、1．0、1．5、2．0cm处进行病理学检查，并对乳腺癌浸润与肿瘤大小、年龄、腋窝淋巴结及肿瘤分期等临床相关性进行分析。结果 100例标本中，分别于0．5、1．0、1．5、2．0cm处发现癌细胞浸润36、26、15、0例，肿瘤浸润距离与肿瘤大小呈正相关，与年龄呈负相关，与肿瘤分期（I、Ⅱ期）无明显相关性。0．5cm浸润距离的腋窝淋巴结阳性率较高，大于1．0cm的浸润距离与腋窝淋巴结状态无相关性。结论 乳腺癌行保乳手术的切除范围至少应为距离肉眼可见肿瘤边缘2．0cm的癌旁组织织。     

乳腺癌浸润相关因素分析及其在保乳手术中的应用

目的探讨乳腺癌保乳手术距肿瘤边缘最佳的切除范围及肿瘤浸润相关因素。方法对100例乳腺癌患者行肿瘤切除的标本分别距肿瘤边缘0.5、1.0、1.5、2.0cm处进行病理学检查,并对乳腺癌浸润与肿瘤大小、年龄、腋窝淋巴结及肿瘤分期等临床相关性进行分析。结果100例标本中,分别于0.5、1.0、1.5、2.0cm处发现癌细胞浸润36、26、15、0例,肿瘤浸润距离与肿瘤大小呈正相关,与年龄呈负相关,与肿瘤分期(Ⅰ、Ⅱ期)无明显相关性。0.5cm浸润距离的腋窝淋巴结阳性率较高,大于1.0cm的浸润距离与腋窝淋巴结状态无相关性。结论乳腺癌行保乳手术的切除范围至少应为距离肉眼可见肿瘤边缘2.0cm的癌旁组织。