乳腺癌保乳手术后局部复发因素的分析

目的:探讨乳腺癌患者行保乳手术治疗后局部复发的相关因素。方法:收集2002年3月—2010年3月行保乳手术治疗的356例乳腺癌患者的临床及随访资料,分析年龄、淋巴结转移、肿瘤直径、人表皮生长因子受体2(HER-2)、雌激素受体(ER)/孕激素受体(PR)与术后肿瘤局部复发的相关性。结果:356例患者的中位随访时间为53(9~120)个月;其中14例(4.3%)患者出现同侧乳房局部复发,16例(4.9%)出现远处转移;5年无远处转移生存率为95.4%,5年总体生存率为99.1%,5年无病生存率为82.3%;乳腺癌患者行保乳治疗手术后2~3年是肿瘤局部复发的高峰时期,单因素以及多因素分析发现,患者的年龄、淋巴结转移及HER-2是肿瘤局部复发的独立危险因素。结论:淋巴结转移以及HER-2与乳腺癌患者行保乳手术后的局部复发相关。

Analysis on Factors of Local Recurrence after Breast-Conserving Surgery in Patients with Breast Cancer

Objective：To explore the factors correlated to breast cancer recurrence after breast-conserving surgery.Methods：The clinical and follow-up medical data of 356 patients with breast cancer after breast-conserving surgery from March 2002 to March 2012 were collected.The correlations of age,lymph node metastasis,tumor diameter,human epidermal growth factor receptor 2 （HER-2）,estrogen receptor （ER） /progesterone receptor（PR） with postoperative tumor local recurrence were analyzed.Results：The median follow-up period was 53（9-120） months.Among the 356 cases,14 cases （4.3％） had local recurrence in ipsilateral breast,while 16 cases （4.9％） had distant metastasis.The 5-year distant metastasis-free survival rate was 95.4％.The 5-year overall survival rate was 99.1％.The 5 year disease-free survival rate was 82.3％.The peak period for local recurrences was 2-3 years after surgery.Univariate analysis and multivariate analysis demonstrated that age,lymph node metastasis and HER-2 were independent risk factors of local recurrence.Conclusions：Age,lymph node metastasis and HER-2 were correlated to local recurrence after breast conserving surgery.