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目的探讨治疗Ⅱ期乳腺癌的较佳方案。方法选择Ⅱ期乳腺癌患者398例,其中保乳手术(局部切除或象限切除)120例,改良根治切除术140例,其中Auchincloss手术(改良Ⅰ式)46例,Patey手术(改良Ⅱ式)41例,Kodama手术53例;Halsted根治切除术138例;治疗后随访5年以上,比较各种手术术式与病人生存率的关系。结果保乳组、改良组和标准组患者5年生存率分别为90.63%、92.86%、93.94%,3组差异均无统计学意义(P﹥0.05);5年局部复发率比较,保乳组6例(6.25%),改良组6例(6.12%),标准组5例(5.05%),3组局部复发率比较,差异均无统计学意义(P﹥0.05)。结论Ⅱ期乳腺癌采用保乳手术、改良根治切除术治疗,远期效果与Halsted根治切除术相同,提倡乳腺癌的手术治疗推行人性化、理性化。
Objective To investigate the better treatment of stage Ⅱ breast cancer. Methods A total of 398 patients with stage Ⅱ breast cancer were selected, including 120 breast conserving surgery (partial resection or quadrant excision) and 140 modified radical mastectomy. Of them, 46 were Auchincloss (modified Ⅰ), Patey (modified Ⅱ) 41 Cases, Kodama surgery in 53 cases; Halsted radical resection in 138 cases; after treatment for more than 5 years, comparing various surgical procedures and patient survival rate. Results The 5-year survival rates of the breast-conserving group, the modified group and the standard group were 90.63%, 92.86% and 93.94% respectively. There was no significant difference between the three groups (P> 0.05) 6 cases (6.25%), 6 cases (6.12%) in the modified group and 5 cases (5.05%) in the standard group. There was no significant difference in the local recurrence rate between the three groups (P> 0.05). Conclusions Breast cancer of stage Ⅱ is treated with conservative surgery and modified radical mastectomy. The long-term effect is the same as that of radical mastectomy. The surgical treatment of breast cancer advocates humaneness and rationalization.