保乳手术结合放化疗在早期乳腺癌治疗中的应用.docxVIP

保乳手术结合放 化疗在早期乳腺癌治 疗中的应用 （作者 :___________单位 : ___________ 邮编 : ___________ ） 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 stage Ⅰ and 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