不同术式对T_1乳腺癌病人的疗效评估

目的：探讨不同术式对Ｔ１乳腺癌的疗效。方法：观察Ｈａｌｓｔｅｄ术、改良根治术和乳房象限切除加腋淋巴结清扫术对２７４例Ｔ１乳腺癌病人预后的影响；并分析全部病人的腋淋巴结转移情况。结果：Ｔ１乳腺癌病人１０年生存率为８４．７％；标准根治术与改良根治术后病人的１０年生存率分别为８０．５石％和８４．１％（Ｐ＞０．０５）；乳房象限切除加腋淋巴结清除术与根治术相比，Ｔ１Ｎ０Ｍ０病人的１０年生存率分别为１００％和９０．４％（Ｐ＞０．０５）；全组腋淋巴结转移率为２７．７％；９７．４％的转移淋巴结位于低位组。结论：３种术式治疗Ｔ１乳腺癌病人的效果相同，从美观及心理因素上考虑，提倡行保守性手术；２／３以上Ｔ１病人无腋淋巴结转移，一律行腋淋巴结清除对预后意义不大，前哨淋巴结活检可以解决这一问题；腋淋巴结转移绝大多数在低位组，在不能进行前哨淋巴结活检的情况下，可仅清除低、中位淋巴结。

Effects of Different Operations on Patients with T1 Breast Cancer.

Objective: To evaluate the effects of different operations on patients with T1 breast cancer. Methods: The out- come of 274 T1 breast cancer patients underwent three different operative procedures were reviewed, and the axilla- ry lymph node status were analysed. Results: Overall 10-year survival rate was 84.7%. The 10-year survival rate in groups of Halsted and modified radical mastectomy was 80.5% and 84.1 %,respectively(p>0.05). Compared the quan- drantectomy plus axillary dissection with the radical mastectomy for T1N0M0 patients, the 10-year survival rate was 100% and 90. 4%,respectively(p>0.05). The rate of axillary lymph node involvement was 27.7%, while 97 .4% of invol- ved nodes were in low axillary group. Conclusions: No Prognostic difference is demonstrated for T1 breast cancer pa- tients treated by three different procedures. Considered the cosmetic and psychologic factors, conservative surgery should be advocated. AS over two thirds of the patients had no axillary lymph node metastasis, axillary dissection of low and middle groups is enough for T1 breast cancer.