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目的:探讨早期乳腺癌保守性外科治疗的效果。方法:我院1990年6月～2000年4月对临床早期癌125例行乳房象限切除术加腋淋巴结清扫术,其中0期3例,Ⅰ期89例,Ⅱ期33例。全组患者术后乳房放疗102例,未放疗23例。浸润性癌围手术期化疗7周。腋淋巴结阳性术后常规放疗,此后6～12个月内追加12～16次化疗。ER阳性服用TAM2～5年。此外,选用同期0、Ⅰ、Ⅱ期仿根治术或根治术常规综合治疗95例做对照观察。结果:1)病理检查:125个象限切除标本中断端阳性10例(8.0%),均以管内癌形式出现。腋淋巴结平均检出16.8枚,阳性率15.2%;2)生存情况:125例随诊,>3年85例,>5年63例,全部生存。仅1例术后2.5年局部复发,1例术后2年骨转移带瘤生存;随诊<3年40例,1例术后1年肺转移带瘤生存;对照组95例,1例肺转移死亡。结论:早期乳腺癌保守性外科治疗与仿根治术,根治术效果相似且能保持乳房良好外形,是Ⅰ、Ⅱ期乳腺癌理想的治疗方法。
Objective: To investigate the effect of conservative surgical treatment of early breast cancer. Methods: From June 1990 to April 2000, 125 cases of preclinical carcinoma were treated by breast quadrant resection and axillary lymph node dissection. There were 3 cases in stage 0, 89 in stage Ⅰ and 33 in stage Ⅱ. The whole group of patients received postoperative breast radiotherapy 102 cases, 23 cases without radiotherapy. Invasive cancer perioperative chemotherapy for 7 weeks. Axillary lymph node-positive conventional radiotherapy, after 6 to 12 months additional 12 to 16 chemotherapy. TAM positive taking TAM 2 ~ 5 years. In addition, the same period of 0, Ⅰ, Ⅱ radical resection or radical conventional conventional treatment of 95 cases for comparison. Results: 1) Pathological examination: 10 cases (8.0%) of the 125 quadrants were found to be positive in the form of intracapsular carcinoma. The average number of axillary lymph nodes was 16.8, with a positive rate of 15.2%. 2) Survival: 125 cases were followed up for> 3 years, 85 cases were> 5 years and 63 cases were alive. Only 1 patient had local recurrence 2.5 years after operation and 1 patient had bone metastasis 2 years after operation. There were 40 patients with follow-up <3 years and 1 patient with lung metastasis one year after operation. There were 95 cases in control group and 1 case of lung Transfer death. Conclusions: Conservative surgical treatment of early breast cancer with imitation of radical mastectomy and radical resection has the similar effect and can maintain the good shape of breast. It is an ideal treatment for stage Ⅰ and Ⅱ breast cancer.