112例早期乳腺癌保乳治疗的中长期疗效分析

目的 评价早期乳腺癌保乳治疗的中、长期疗效.方法 回顾分析2006年1月至2012年12月行保乳根治术治疗的112例早期乳腺癌患者的临床特征、复发、转移及生存资料.112例患者均接受肿块局部扩大切除＋腋窝淋巴结清扫术,术后根据情况行放疗、化疗、内分泌治疗等.结果 中位随访时间为40个月,平均随访时间为42.2个月（3～84个月）.乳腺局部复发2例,远处转移10例,死亡4例,2例乳腺局部复发后行乳房单纯切除术.发生远处转移的部位是肺转移4例、肝转移2例、骨转移4例、脑转移3例.Kaplan-Meier生存分析显示,112例患者3、5年的生存率分别是98.6％和96.4％,3、5年无病生存率分别是96.5％和93.1％.83例肿瘤大小≤2 cm患者的3、5年生存率高于其余29例肿瘤直径＞2 cm者（P＜0.05）;68例给予内分泌治疗患者的3、5年生存率较44例未接受内分泌治疗者高（P＜0.05）;腋窝淋巴结阳性患者的3、5年无病生存率低于腋窝淋巴结阴性者（P＜0.05）.结论 在严格掌握保乳指征的前提下,早期乳腺癌病例进行保乳治疗安全可行.

Clinical Analysis of Mid-long Term Outcomes of 112 Early Breast Cancer Patients With Breastconservingtreatment

Objective To evaluate the mid- long term outcomes of patients with early breast cancer who received breast - conserving treatment（BCT）. Methods The data of 112 early breast cancer patients, who re- ceived BCT in Chifeng City Hospital from January 1 st, 2006 to December 31 st. 2012. were collected and ana- lyzed retrospectively. All the cases received extensive lumpectomy or quadrant resection plus axillary lymphnodes dissection, and then radiotherapy, chemotherapy or endocrinothempy were arranged postoperatively according to the clinical features of patients. Results The median time of follow - up were 40 months and the mean time were42 months（3- 84 months）. Two caes got local recurrences; 10 eases had distant metastases, and 4 cases died, Two ease received mastectomy because of local recurrence. As to the location of metastasis, 4 cases were found in lungs, 2 cases in livers, 3 cases in brains and 4 cases in hones. Kaplan - Meier method showed the 3 - yearand 5 - year overall survival rates were 98.6 % and96.4 %. respectively. The 3 - year and 5 - year disease - free survival rates were 96.5 % and 93.1% respectively. The 3 -, 5 - yea roverall survival rates of 29 patients with larger tumor（ ~ 2cm）were lower than those of 83 patients with smaller tumor（42 cm）, showing with sig- nificant differences（P （0.05）, and the 3 - , 5 - year overall survival rates of 44 patients without endocrinotherapy were significantly lower than those of 68 patients receiving endocrinotherapy（P 〈 0.05）. The 3 -, 5 -, year disease free survival rates of lymph nodes positive patients were significantly lower than those of lymph nodes negative patients（P 〈 0.05）. Conclusion Conforming to the indication of breast conservation, BCT is safe and feasible for early breast cancer.