较大乳腺癌新辅助化疗后保乳手术24例报告

目的探讨较大乳腺癌新辅助化疗后保乳手术的可行性。方法2003年6月～2006年9月我院对24例肿瘤直径〉3cm的乳腺癌行空心针穿刺活检,以紫杉醇和（或）表阿霉素为主的联合新辅助化疗2～4个周期,化疗后7～10d行保乳手术。结果24例接受2～4个周期的新辅助化疗,临床完全缓解率（CR）12.5%（3/24）,部分缓解率（PR）87.5%（21/24）,病理完全缓解率（pCR）8.3%（2/24）。14例成功完成保留乳房手术,保留乳房率58.3%（14/24）,7例不符合保留乳房规范直接行改良根治术,3例术中冰冻切缘阳性改行改良根治术。24例随访5～44个月,中位时间24个月,无局部复发和远处转移。结论对于较大的乳腺癌,采用新辅助化疗缩小降期后,使相当部分患者获得保乳机会。

Breast Conservative Surgery for Large Breast Carcinoma after Neoadjuvant Chemotherapy: Report of 24 Cases

Objective To investigate the feasibility of breast conservative surgery for large breast carcinoma(over 3 cm in diameter)after neoadjuvant chemotherapy.Methods A total of 24 patients with breast carcinoma larger than 3 cm in diameter underwent core needle biopsy and neoadjuvant chemotherapy with paclitaxel and/or epirubicin in our hospital from June 2003 to September 2006.The chemotherapy was carried out for 2 to 4 cycles,and then breast conservative surgery was performed in 7 to 10 days.Results After the neoadjuvant chemotherapy,3(12.5%)patients achieved CR,and 21(87.5%)had PR.Pathological CR was detected in 2(8.3%)of the patients.The breast conservative surgery was completed in 14 cases(58.3%),10 patients were converted to modified radical resection.The patients was followed up for 5 to 44 months with a median of 24,during which none of them had recurrence or distant metastasis.Conclusions For patients with large breast carcinoma,breast conservative surgery is feasible after neoadjuvant chemotherapy.