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目的探讨早期乳腺癌患者保乳手术的适应证、手术方法及注意事项。方法回顾分析近年我院保乳手术28例患者的临床资料。结果本组患者肿瘤直径为0.5～2.5cm,平均1.5cm;肿瘤位于外上象限16例,外下象限2例,内上象限9例,内下象限1例。手术切口采用单切口15例,双切口13例。肿瘤切除后乳房缺损的修复方法采用直接缝合腺体20例、腋侧胸背部皮下组织瓣修复乳腺缺损7例、背阔肌瓣转移乳房成型术1例。术后并发症包括皮下积液2例,上肢水肿1例,下肢静脉血栓1例。术后病理均为浸润型导管癌,淋巴结转移4例。术后均接受放疗和6个周期的化疗,ER和(或)PR检测阳性者接受内分泌治疗。随访6～45个月,平均19个月。全部患者外形满意,随访无肿瘤复发和远处转移。结论对于选择合适的早期乳腺癌病例,保留乳房的乳腺癌切除术是标准术式,手术安全,术后乳房外形正常,患者生存质量提高。
Objective To investigate the indications, surgical methods and precautions of breast conserving surgery in patients with early breast cancer. Methods Retrospective analysis of 28 cases of breast conserving surgery in our hospital in recent years, the clinical data. Results The diameter of tumor in this group was 0.5 ~ 2.5cm with an average of 1.5cm. The tumor was located in the outer upper quadrant in 16 cases, the outer quadrant in 2 cases, the upper quadrant in 9 cases and the lower quadrant in 1 case. Surgical incision with a single incision in 15 cases, double incision in 13 cases. Tumor resection of breast defect repair method using direct suture of the gland in 20 cases, axillary chest and subcutaneous tissue flap repair of breast defects in 7 cases, latissimus dorsi flap transfer of breast surgery in 1 case. Postoperative complications include subcutaneous fluid in 2 cases, upper extremity edema in 1 case, lower limb venous thrombosis in 1 case. Postoperative pathology was invasive ductal carcinoma, lymph node metastasis in 4 cases. All patients underwent radiotherapy and 6 cycles of chemotherapy after surgery. Patients with positive ER and / or PR tests underwent endocrine therapy. Followed up for 6 to 45 months, an average of 19 months. All patients satisfied with the shape, follow-up no tumor recurrence and distant metastasis. Conclusion For the selection of suitable cases of early breast cancer, breast conserving breast cancer surgery is the standard surgical procedures, surgery, postoperative breast shape is normal, patients with improved quality of life.