乳腺癌保守手术治疗后同侧局部复发危险因素的探讨

目的 探讨临床、病理因素及辅助治疗对乳腺癌保守手术合并放疗后同侧局部复发的影响。方法 应用Kaplan-Meier方法和Cox比例风险模型对126例保乳术合并放疗的早期乳腺癌患者进行回顾性分析。结果 多因素条件下56岁以上乳腺癌患者保乳手术合并放疗后同侧局部复发的风险比为2.17,EIC阳性的风险比为3.46,病灶切缘不净为1.68,无辅助TAM治疗组的风险比为1.52。结论 年龄、EIC及切缘情况对保乳术合并放疗后同侧局部复发有重要的影响,同时辅助TAM治疗可以减少局部复发的风险。

Exploration of risk factors for ipsilateral breast tumor recurrence after conservative surgery and irradiation of breast cancer

Objective To explore the impact of clinical, pathologic and treatment-related factors on ipsi-lateral breast tumor recurrence (IBTR) after conservative surgery and irradiation of breast cancer.Methods Kaplan-Meier method and Cox regression model were used to estimate risk of IBTR in 126 patients with clinical stage-I or II breast cancer treated with conservative surgery and irradiation. Results The results showed that patients older than 55 years, presence of extensive intraductal component (EIC) , margin positive and using adjuvant tamox-ifen (TAM) were significant prognostic factors for IBTR after conservative surgery and irradiation of breast cancer. The values of hazard ratios of older than 56 years, positive EIC, positive margin and without adjuvant TAM treatment were 2.17, 3.46, 1.68 and 1.52 respectively.Conclusion Patients older than 55 years and using adjuvant TAM treatment can decrease the risk of IBTR after conservative surgery and radiation. Meanwhile presence of EIC and margin positive can increase the risk of IBTR.