[1]王永胜,孙敏,刘岩松.乳腺癌保留乳房治疗远期疗效的研究[J].中华乳腺病杂志(电子版),2007,1(3):28.
　WANG Yong-sheng,SUN Min,LIU Yan-song.Long-term results of breast conserving therapy for breast caner[J].Chinese Journal of Breast Disease (Electronic Version),2007,1(3):28.
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乳腺癌保留乳房治疗远期疗效的研究()

中华乳腺病杂志（电子版）[ISSN:1674-0807/CN:11-9146/R]

卷:
第1卷
期数:
2007年3期
页码:
28
栏目:
临床研究
出版日期:
2007-06-01

文章信息/Info

Title:
Long-term results of breast conserving therapy for breast caner
作者:
王永胜;孙敏;刘岩松
山东省肿瘤医院乳腺病中心
Author(s):
WANG Yong-sheng;SUN Min;LIU Yan-song
关键词:
乳腺癌; 保留乳房治疗; 同侧乳腺复发; 美容效果
摘要:
目的　探讨临床Ⅰ、Ⅱ期乳腺癌选择性行乳腺癌保留乳房治疗（ＢＣＴ）的远期生存、同侧乳腺复发（ＩＢＲ）、美容效果及其相关因素。方法　对１９８５年１０月至２０００年１２月收治的２７０例Ⅰ、Ⅱ期乳腺癌患者进行ＢＣＴ远期疗效的临床研究。乳腺癌保乳手术先后采用乳腺象限／区段切除术及肿瘤扩大切除术，联合全腋窝淋巴结清扫术。术后放射治疗先后采用６０Ｃｏ及加速器全乳放射治疗及瘤床缩野照射。结果　在１０年的中位随访时间内，２７０例ＢＣＴ患者１０年总生存率８３．７％、ＩＢＲ８．５％、远处转移率２３．７％。患者年龄、肿瘤大小、病理组织学类型、腋窝淋巴结转移状况等临床病理因素对ＢＣＴ后ＩＢＲ无显著性影响（均Ｐ＞０．０５），切缘阳性、术后未行全乳照射的患者ＩＢＲ显著升高（均Ｐ＝０．０００）。在确保切缘阴性的前提下，不同切除范围的手术方式对ＩＢＲ无显著性影响（Ｐ＝０．７９９），但切除范围较大的区段／象限切除术对ＢＣＴ后乳房美容效果有显著不良影响（优秀Ｐ＝０．０４３，优秀＋良好Ｐ＝０．００５）。结论　①临床Ⅰ、Ⅱ期乳腺癌选择性行ＢＣＴ有较高的远期疗效、较好的美容效果和较低的ＩＢＲ，可以安全地替代乳房切除性手术。②确保切缘阴性及接受术后全乳放射治疗仍是现阶段乳腺癌ＢＣＴ的金标准。③在确保切缘阴性的前提下，切除范围较小的肿瘤扩大切除术有较好的美容效果和相同的治疗效果。

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更新日期/Last Update: 2007-01-20