乳腺癌保乳治疗指征初探

目的 探讨原发肿瘤直径大干4．0cm的乳腺癌是否适于保乳治疗。方法 将65例接受保乳治疗的乳腺癌患者按原发肿瘤最大直径的大小分为A、B两组。A组直径4．0～6．0cm，B组直径≤4．0cm。保乳手术前后均给予CAF方案化疗一次。然后再分别给予总剂量为70Gy的外照射。放疗的同时配合化疗。雌、孕激素受体阳性者均给予TAM口服。结果 随访5年，术后局部复发率，A组为5．6％，B组为2．1％；5年生存率，A组为83．3％(15／18)，B组为89．4％(42／47)。结论 原发肿瘤直径4．0cm以上的乳腺癌配合放疗及全身治疗。可初步被认为是保乳治疗的指征。

An exploration of indications of conservative therapy to a breast cancer

Objective ]To explore whether a breast cancer which the longest diameter of a primary tumor is more than 4.0cm be suitable for conservative therapy. Abstract Objective ]To explore whether a breast cancer which the longest diameter of a primary tumor is more than 4.0cm be suitable for conservative therapy.To explore whether a breast cancer which the longest diameter of a primary tumor is more than 4.0cm be suitable for conservative therapy. To divide 65 patients into two groups according to the longest diameter of the primary tumor of the breast.Give one course of chemotherapy(CAF) to each patient before and after the operation,then begin the external irradiation with a total dose of 70Gy respectively as well as the chemotherapy and endocrine treatment(TAM). The postoperative regional reoccurrence rates after 5-year follow-up are 5.6% to group A and 2.1% to group B,whereas 5-year survival rates are 83.3% to group A and 89.4% to group B.[Conclusion] The breast cancer which the longest diameter of a primary tumor is more than 4.0cm,if combined with radiation therapy and chemotherapy,can also be primarily regarded as the indication of the conservative operation to a breast cancer.