保乳术与改良根治术治疗早期乳腺癌疗效对比分析

目的：对比分析保乳手术与改良根治术治疗早期乳腺癌的临床效果。方法：回顾性分析我院在2009年1月～2011年2月收治的84例早期乳腺癌患者,按手术方式的不同分为保乳手术治疗组（观察组）和改良根治术治疗组（对照组）,两组各42例,比较两组患者的临床疗效。结果：观察组术后拔管时间短、并发症发生率低,并且美容效果评价的优良率明显高于对照组,两组的生存率及无病生存率相似,差异无统计学意义（P〉0．05）。结论：保乳手术加放疗可达到与改良根治术相似的生存率,且手术并发症发生率低,美容效果好,对治疗早期乳腺癌有明显优势,值得在临床上推广应用。     

早期乳腺癌保乳手术加放疗32例临床分析

目的探讨保乳手术加放疗对早期乳腺癌的临床疗效。方法选择2006年1月—2007年9月,收治的Ⅰ、Ⅱ期乳腺癌患者32例,采用肿瘤扩大切除术,术后3周开始根治性放疗。结果全部患者患侧乳房与对侧乳房基本对称,无明显纤维化,患者上肢活动灵活,无水肿,局部无复发,皮肤弹性良,均对术后乳房外观较满意。结论保乳手术加放疗能够兼顾治疗效果与美容效果,适用于早期乳腺癌的治疗,但尚需远期随访。     

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。     

60例老年乳腺癌保乳治疗临床效果

目的通过老年人乳腺癌保乳治疗和改良根治术的比较，探讨保乳治疗老年人乳腺癌的疗效。方法回顾分析2003年1月-2006年3月于我院接受保乳手术治疗的60例老年乳腺癌患者临床资料，其中Ⅰ期41例，Ⅱ期19例（ⅡA期16例、ⅡB期3例）。手术方式为肿瘤广泛切除术或象限切除术，联合腋窝淋巴结清扫。术后常规行辅助放疗、化疗和内分泌治疗。并与同期60例行改良根治术常规综合治疗的老年乳腺癌患者（Ⅰ期32例、ⅡA期16例、ⅡB期12例）做临床疗效对比研究。结果经过术后2年的随访，保乳手术组无局部复发及远处转移，全部生存。改良根治术组局部复发率为0（0／60），远处转移率1．67％（1／60），手术至远处转移时间16个月，转移部位为左锁骨上淋巴结。两个组的近期疗效差异无统计学意义（P〉0．05）。结论老年人乳腺癌保乳治疗与仿根治术相比较能取得满意的疗效。规范化的切除和术后化疗、放疗、内分泌治疗等综合治疗是保乳治疗成功的关键。保乳治疗是老年乳腺癌理想的治疗方法。     

早期乳腺癌保留乳房治疗42例分析

目的本文探讨了早期乳腺癌的最佳治疗方式。方法对42例早期乳腺癌进行保乳手术并与传统根治术进行比较。其中0期2例,I期29例,Ⅱ期11例。42行乳房区段切除加腋窝淋巴结清扫,全部患者术后2周内放疗。结果两组术后均获随诊,随诊满5～9年,平均随诊时间65个月,保乳手术和传统根治术在5年生存率和复发率比较差异无明显意义(P>0.05)。结论早期乳腺癌采用保乳手术治疗效果满意。     

早期乳腺癌保乳手术与改良根治术的疗效比较

随着乳腺癌诊断和治疗技术的不断进展,欧美国家保乳手术已成为早期乳腺癌的首选术式。但在我国保乳手术仅在少数医院开展。为比较保乳手术与改良根治术的临床效果。我们选取1996—2003年经治的早期乳腺癌保乳手术56例,改良根治术68例,回顾性分析其随访资料。1资料与方法1.1一般资料124例乳腺癌全部为女性患者。其中保乳手术56例,年龄27~48岁,平均37岁。改良根治术68例,年龄30~69岁,平均59.2岁。肿瘤位于右侧乳腺69例,左侧乳腺55例。位于外上象限66例,占53.2%;外下象限12例,占9.7%;乳晕下9例,占7.3%;内上象限24例,占19.4%,内下象限13例,占10.…     

早期乳腺癌保乳手术40例临床观察

目的研究规范病例的选择、手术的范围及术后辅助治疗的方式。方法对40例早期乳腺癌病例实施了保乳治疗。手术指征:肿瘤最大直径≥2cm,周围型肿块,病人有保乳意愿。手术方式为肿块广泛切除加腋窝淋巴结清扫;肿块位于乳腺外上象限,原发灶与腋窝行整块切除,术后常规行辅助治疗。结果手术标本各个切缘的组织病理切片检查未发现肿瘤累及,随访期5～9年,其5年生存率97.5%,局部复发率5%,乳房总优良率90%。结论对早期乳腺癌,如病例选择适当,在其有良好的外科手术和放疗技术的单位,采用保守性手术加放疗可取得长期满意的肿瘤局部控制和良好的乳房美观效果。     

58例早期乳腺癌保乳术后放疗疗效观察

[目的]分析和探讨早期乳腺癌保乳术后放疗的疗效。[方法]58例经病理证实的早期乳腺癌,34例进行单纯放疗、24例进行术后放疗结合化疗,并进行疗效对照。[结果]保乳手术后单纯放疗组放疗后3年、5年生存率略高于保乳手术后放疗结合化疗组的患者,但两组差异无统计学意义﹙P﹥0.05﹚。[结论]保乳手术后单纯放疗或结合放、化疗对早期乳腺癌疗效与早期乳腺癌改良根治术后结合放、化疗疗效相当。     

早期乳腺癌保乳术后APBI技术的研究进展

放射治疗(RT)是乳腺癌治疗的重要组成部分。对于早期乳腺癌保乳手术患者,包括浸润性癌、原位癌早期浸润和原位癌的患者,予以术后全乳腺放疗(WBI)可达到显著降低局部复发率的目的,已成为早期乳腺癌的标准治疗模式之一。随着现代放疗设备和技术的发展,加速部分乳腺照射(APBI)得到广泛的认同并应用于临床。     

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.     

Preparation of the internal mammary artery

The internal mammary artery is the best currently available conduit in coronary artery bypass surgery. It is a living arterial graft with intact smooth muscle and its efficiency as a conduit therefore depends to a large extent on the way it is mobilized and prepared for grafting. This article discusses the anatomical, technical and pharmacological aspects of the surgical preparation of the internal mammary artery for coronary grafting.     

Direct revascularization of the myocardium using the internal mammary artery

The best graft in coronary bypass operations is the internal mammary artery (IMA) as its rate of staying open for long term is better than that of the vena saphena magna. The authors present the operative and postoperative results of their first 161 patients who were subjected to IMA grafting. 126 were men and 35 women of the patients and the average age was 50.2 years. Before the operation the majority of the patients belonged to NYHA III state (69.6%). 86 patients (53.4%) had myocardial infarction before the operation, 50.3% were operated on because of 3 blood vessel diseases and the stricture of the main trunk was confirmed in 12.4%. 128 patients underwent only coronary bypass operation, in the others thrombendarterectomy (17 patients), valvular operation (11 patients) and resection of the left ventricular aneurysma (5) were carried out simultaneously. The IMA graft was placed in the majority of the cases on the LAD (70.8%) or as a sequential anastomosis on the LAD-diagonal system (21.1%). The average number of peripheral anastomoses was 2.8 anastomoses patient. 2.5% was the rate of early mortality (4 patients), reoperation was performed in 10 cases because of bleeding or tamponade and perioperative infarction occurred in 8 cases. 3.1% was the rate of late mortality (5 patients). The average follow-up examination time was 12.7 months (3-39 months). At the postoperative examinations 88.8% of the patients were free of angina and 108 patients got into NYHA I state after the operation. Of the 43 control bicycle ergometric examinations 35 were negative and 8 positive.(ABSTRACT TRUNCATED AT 250 WORDS)     

Dietary fat and mammary carcinogenesis

Evidence that dietary fat has an influence on carcinogenesis comes from both epidemiological data and experiments with animals. The experimental studies have indicated that dietary fat acts primarily as a promoter of carcinogenesis and that the effect depends on the type as well as the amount of fat in the diet. Vegetable oils containing polyunsaturated fatty acids of the linoleic acid family (n‐6) have been shown to enhance mammary tumorigenesis, but a fish oil containing polyunsaturated fatty acids of the linolenic acid family (n‐3) had an inhibitory effect at higher levels of intake. These and other findings suggest that the effect may be related to prostaglandins or other biologically active products of polyunsaturated fatty acids. Epidemiological data show a positive correlation between dietary fat and mortality from cancer at various sites, and this is supported by results of animal experiments in the case of colon cancer and pancreatic cancer as well as breast cancer. In the epidemiological data, cancer mortality shows strong positive correlations with total dietary fat and with animal fat, but not with fat derived from plants. Fats and oils used as spreads, cooking fats, and salad oils are the main source of fat in the American diet. Other major sources are meats and dairy products. Fat intake could probably be reduced substantially without serious deleterious effects, and this might help to decrease the risk of developing certain types of cancer.

(Nutr Cancer 6, 254–259, 1985)     

5个办法教您自查乳腺癌

曾经有一位有乳腺癌家族史的女人,还是在陪她妈妈看病的时候就认认真真地向大夫学会了乳腺自查。她知道,母亲的病情就是既不会做乳腺自查,又不去医院做临床检查而耽误的。从30多岁起,这个女人每个月都会给自己做一次乳腺自查,每次自查后她都会长长舒口气。然而,有一次她却倒吸了一口冷气,因为她摸出一个大约1公分大的肿块。经临床确诊,为一期乳癌肿瘤。因为发现得及时,手术得好,之后又按医嘱,除了自查还定期去医院做复查。于是,10年过去了,这个女人的乳腺状况一直良好。