早期乳腺癌保乳手术35例临床分析

目的探讨早期乳腺癌保乳手术的适应证、手术方法及临床疗效。方法将72例早期乳腺癌患者随机分为两组，保乳组：35例实施肿块局部扩大切除＋腋窝淋巴结清扫；改良根治组：37例施行改良根治术，两组术后均予以辅助放疗和全身化疗。结果保乳组术后1、3及5a的复发率分别为0％、2．86％、8．57％，生存率分别为100％、97．14％、94．29％；改良根治组术后1、3及5a的复发率分别为0％、2．70％、5．41％，生存率分别为100％、97．30％、94．59％。比较两组病例的术后复发率及生存率，差异无统计学意义（P〉0．05）。保乳组整形效果满意，生活质量良好。结论保乳手术联合辅助放疗和全身化疗治疗早期乳腺癌疗效肯定，美容效果良好，值得临床应用。

Clinical analysis of breast conserving surgery for early-stage breast cancer in 35 cases

[Objective] To explore the indication,surgical techniques and clinical effect of breast conserving surgery in the treatment of early-stage breast cancer. [Methods] 72 patients with early-stage breast cancer were randomly divided into 2 groups: breast conserving surgery group and modified radical mastectomy group. Breast conserving surgery group: enlarged local excision of tumor combined with axillary lymph node dissection was performed in 35 cases; Modified radical mastectomy group: modified radical mastectomy was performed in 37 cases. Adjuvant radiotherapy and systemic chemotherapy were performed in the 2 groups. [Results] Recurrence rate in breast conserving group was 0%, 2.86%, 8.57% in postoperative 1, 3, 5 years and survival rate was 100%, 97.14%, 94.29%, respectively; Recurrence rate in modified radical mastectomy group was 0%, 2.70%, 5.41% in postoperative 1,3,5 years and survival rate was 100%, 97.30%, 94.59%, respectively. There was no significant difference in postoperative recurrence rate and survival rate between the 2 groups(P >0.05). Cosmetic effect of breast and quality of life in breast conserving group was favourable. [Conclusion] Breast conserving surgery combined with adjuvant radiotherapy and systemic chemotherapy is deserving clinical application for early-stage breast cancer because of the reliable curative effect and favourable cosmetic result.