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目的通过对早期乳腺癌保乳手术后放疗与改良根治术后疗效比较分析,探讨早期乳腺癌最佳治疗方案。方法回顾性分析从2004年3月一2005年12月我院181例I期,Ⅱ期乳腺癌病人。按她们接受的手术治疗的方式,分成保乳手术组和改良根治术组,其中保乳组79例,术后常规行全乳适型调强放疗和瘤床加量放疗。改良根治术组102例,改良根治术后是否采取放射治疗主要根据肿瘤大小,部位和腋窝淋巴结转移情况而定,其中有68例病人接受放疗。两组患者术后均接受以CEF方案为主的化疗,ER/PR阳性的患者均给予内分泌治疗。结果保乳组患者术后3年的生存率,远处转移率,局部复发率分别为97.4%,1.2%,2.5%;改良根治术组患者分别为95%,4.9%,3.9%,两组相比均无显著性差异(P>0.05)。结论保乳手术十术后放射治疗治疗早期乳腺癌能得到和改良根治术相同的疗效,具有创伤小、痛苦少、恢复快、生活质量较高且外型美观等优点,因此在临床上对早期乳腺癌可推广保乳综合治疗方法的应用。
Objective To compare the efficacy of radiotherapy and modified radical mastectomy after breast-conserving surgery in early breast cancer to explore the best treatment for early breast cancer. Methods Retrospective analysis from March 2004 to December 2005 in our hospital 181 cases of stage I, Ⅱ breast cancer patients. According to the surgical treatment they accepted, they were divided into breast-conserving surgery group and modified radical mastectomy group, among which breast-conserving group was given 79 cases. Modified radical mastectomy group of 102 cases, whether radical radiotherapy after radical mastectomy is mainly based on tumor size, location and axillary lymph node metastasis may be, of which 68 patients received radiotherapy. Both groups received postoperative CEF-based chemotherapy, and both ER / PR-positive patients received endocrine therapy. Results The survival rate, distant metastasis rate and local recurrence rate of breast-conserving group were 97.4%, 1.2% and 2.5% respectively after three years; 95%, 4.9% and 3.9% in modified radical mastectomy group, respectively No significant difference (P> 0.05). Conclusion Ten breast-conserving surgery radiotherapy for early breast cancer can get the same curative effect as modified radical mastectomy, which has the advantages of less trauma, less pain, quicker recovery, higher quality of life and good appearance. Therefore, Breast cancer can promote the application of comprehensive breast-conserving treatment.