保乳手术结合放 化疗在早期乳腺癌治疗中应用.docVIP

保乳手术结合放 化疗在早期乳腺癌治疗中应用 　 作者：孟旭莉 杨红健 谢尚闹 李涛 丁小文 【摘要】 目的 评估保乳手术结合放、化疗综合治疗早期乳腺癌的疗效。 方法 对2000年3月至2003年3月手术治疗乳腺癌41例患者进行回顾性研究, 41例均行包括原发灶肿块在内的象限切除，35例加行腋窝淋巴结清扫。手术后均行放、化疗，放疗前化疗1个周期,完成放疗之后再化疗（CMF或CEF方案）5个周期。ER、PR阳性者,加用内分泌治疗。 结果 病理检查Ⅰ期19例、Ⅱ期22例。随访6～56个月。1例出现上肢水肿，有2例局部复发，行补救性改良根治术，分别随访23个月及86个月至今，无远处转移及死亡。2例出现乳房的纤维化、局部疼痛。美容效果满意率为92%。结论 选择部分Ⅰ～Ⅱ期乳腺癌患者行保乳手术治疗,乳房外形及临床疗效满意,而且可以提高生活质量。 【关键词】 保乳手术 早期乳腺癌 综合疗法 美容效果 　　【Abstract】 Objective To give a Clinical evaluation of breast conservation operation combining with radiochemotherapy in treating early breast cancer . Methods A retrospective review was made to the 41 patients of breast cancer who had operation from March ,2000 to March ,2003. All the 41 patients had quadrant resection including the primary lesion , 35 patients also had the axillary nodes dissection. They all had radiochemotherapy postoperatively , one cycle of chemotherapy before radiotherapy and 5 cycles afterwards (CMF or CEF protocol). Endocrine therapy was added in case of ER(+) and PR(+). Results Pathological diagnosis showed 19 cases of stageⅠand 22 of stage Ⅱ. The follow-up was 6～56 months . Edema of the upper extremity occurred in one case , local reoccurrence happened in two cases , salvage radical surgery was applied , with follow-up of 23 and 86 monther respectively till now , no distant metastasis or death were found .Fibrous degeneration and localized pain occurred in two cases . Satisfactory rate of cosmetic result was 92%. Conclusions By breast conservation operation in part of the patients with breast cancer of Ⅰ～Ⅱ stage, not only the breast shape and clinical therapeutic effect but an improvement in life quality could be achieved . 　　【Key words】 breast conservation operation early breast cancer combined therapy cosmetic result 　　目前早期乳腺癌行保乳手术结合放、化疗的综合疗法已成为常规的治疗方法之一，乳腺癌保乳术在欧美国家已成为Ⅰ、Ⅱ期乳腺癌的首选术式，本院2000年3月至2003年3月，乳腺癌行保乳治疗41例，现报告如下。 　　1 资料与方法 　　1.1 一般资料 　　患者均为女性；年龄28～74岁，中位年龄40岁。绝经前34例。肿瘤位于左侧24例，右侧17例，外上象限17例，外下象限11例，内上象限6例，内下象限7例。肿瘤最大直径3cm，平均2.2cm，距乳晕平均3.8cm。