改良根治加带蒂背阔肌皮瓣移植术治疗局部晚期乳腺癌25例体会.docVIP

改良根治加带蒂背阔肌皮瓣移植术治疗局部晚期乳腺癌25例体会【摘要】 目的 探讨乳腺癌改良根治加带蒂背阔肌皮瓣移植术在针对局部晚期乳腺癌的治疗价值。 方法 阳江市人民医院乳腺科2008年12月至2010年12月对25例癌肿侵犯皮肤的局部晚期乳腺癌进行新辅助化疗后，予乳腺癌改良根治加带蒂背阔肌皮瓣移植术治疗。 结果 所有的病例治疗后随访1年，25例患者手术无1例出现严重并发症，患者生活质量佳，21例复查乳腺彩超、腹部B超、胸片、全身骨扫描等检查，未发现局部和淋巴结复发及远处转移，2例出现骨转移，1例出现腋窝复发，1例肺转移后死亡。 结论 乳腺癌改良根治加带蒂背阔肌皮瓣移植术针对部分癌肿侵犯皮肤的局部晚期乳腺癌有较重大的临床应用。 【关键词】 局部晚期乳腺癌；乳腺癌改良根治术；带蒂背阔肌皮瓣移植术  Experience of the treatment for locally advanced breast cancer in 25 cases by modified radical mastectomy with pedicled latissimus dorsi muscle flap transplantation CHEN Ji-shang， CHEN Gui-chou， LIN Jin-biao， et al.Breast Surgery of The Peoples Hospital of Yangjiang City, Yangjiang 529500,China  【Abstract】 Objective To explore value of the treatment of modified radical mastectomy for breast cancer with pedicled latissimus dorsi muscle flap transplantation for locally advanced breast cancer. Methods From December 2008 to December 2010, 25 patients of locally advanced breast cancer with skin involvement was treated by modified radical with pedicled latissimus dorsi muscle flap transplantation, after neoadjuvant chemotherapy. Results All the cases were followed up for 1 year, 21 cases were found with no local recurrence and distant metastasis and good on quality of life,2 cases were found with bone metastasis, 1 cases were found with axillary recurrence, 1 cases was dead after pulmonary metastasisbone. Conclusion Modified radical mastectomy for breast cancer with pedicled latissimus dorsi muscle flap transplantation have a significant clinical application on the treatment to locally advanced breast cancer with skin involvement. 【Key words】 Locally advanced breast cancer; Modified radical mastectomy for breast cancer; The pedicled latissimus dorsi muscle flap transplantation  局部晚期乳腺癌，随着乳腺癌发病率剧增，临床日见增多。由于局部晚期乳腺癌延误手术治疗机会，临床治疗效果欠佳，预后极差，尤其是癌肿侵犯皮肤，后期往往皮肤破溃感染，患者生活质量差。这部分患者，应该获得足够临床重视。但局部晚期乳腺癌目前在治疗上存在严重的争议及分歧［1］，因此，大多数局部晚期乳腺癌患者得不到有效治疗和改善生活质量等妥善处理。我院乳腺科2008年12月至2010年12月对25例癌肿侵犯皮肤的局部晚期乳腺癌进行新辅助化疗后，予