早期乳腺癌外科保守性手术治疗的疗效观察

目的　探讨早期乳腺癌保守性外科治疗的效果。方法　对临床早期乳腺癌 1 2 5例行乳房象限切除术加腋淋巴结清扫术 ,其中 0期 3例 ,Ⅰ期 89例 ,Ⅱ期 33例 ,全组患者术后乳房放疗 1 0 2例 ,未放疗 2 3例 ,浸润性癌围手术期化疗 7周 ,腋淋巴结阳性术后常规放疗 ,此后 6～ 1 2个月内追加 1 2～ 1 6次化疗。ER阳性服用TAM 2～ 5年。此外 ,选用同期 0～Ⅱ期仿根治术或根治术常规综合治疗 95例作对照观察。结果　 ( 1 )病理检查 :1 2 5个象限切除标本中断端阳性 1 0例( 80 % ) ,均以管内癌形式出现。腋淋巴结平均检出 1 6 8枚 ,阳性率 1 5 2 % ;( 2 )生存情况 :1 2 5例随诊 ,>3年 85例 ,>5年 6 3例 ,全部存活 ,仅 1例术后 2 5年局部复发 ,1例术后 2年骨转移带瘤生存 :随诊 <3年 4 0例 ,1例术后 1年肺转移带瘤生存 ;对照组 95例 ,1例肺转移死亡。结论　早期乳腺癌保守性外科治疗与仿根治术 ,根治术效果相似且能保持乳房良好外形 ,是Ⅰ ,Ⅱ期乳癌理想的治疗方法

Observe the Effect of Early Breast Carcinoma after the Conservative Surgery

Objective To explore the effect of early breast carcinoma after conservative surgery. Methods We had cured 125 patients with clinical early breast carcinoma, from June, 1980 to April, 2001 by quadrantectomy and axillary dessection. Among them, 3 cases were in stage 0, 89 cases in stage Ⅰ, 33 cases in stage Ⅱ. 102 cases had been given radiotherapy, and 23 cases hadn't. The invasive carcinoma was given perioperative chemotherapy for 7 weeks. The patients, with postive axillary lymphnodes had received general radiotherapy in 6 to 12 monthes after operation. ER(+)patients took TAM in 2-5 years. Otherwise, we chosed 95 cases, in the same time, as comparative group, which were operated by modify or radical mastectomy and routine combinative treatment in clinical stage 0, Ⅰ, Ⅱ. Results (1) Pathological examation The cutting margin specimens being postive are 10 cases (80%) in the 125 patients, after quadrantectomy, and are all were intraductal carcinoma. 168 axillary lympnodes are postive, taking 15.2 percent of all. (2) survial condition of 125 cases, 85 cases were followed up over 3 years, 63 cases over 5 years. Only 1 case recurred at 2.5 years of the postoperation. 1 case with bone mstastases after the operation 2 year still live. In the comparative group, 1 case with lung mastasasis died. Conclusion It is same that between early breast carcinoma being given conservative surgery and modify or radical mastectomy. Otherwise, the former way can keep the mama with good shap. So it is a ideal therapy for clinical stage Ⅰ, Ⅱ.