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目的:术前化疗可以使部分局限性进展期乳腺癌病人接受保乳手术。然而这种保乳手术和乳腺癌根治术的疗效比较还不清楚,该研究的目的即在于探讨术前化疗后保乳术与乳腺癌根治术治疗局限性进展期乳腺癌的疗效。方法:从2003年5月到2008年3月,135例临床分期Ⅱ或Ⅲ的乳腺癌病人纳入本研究,所有病人入院时进行手术方式评估,然后接受4程术前化疗,化疗后重新进行手术方式评估,对满足标准的病人行保乳术,其他病人行改良乳腺癌根治术。记录两种术式病人的治疗前后的临床指标及预后。结果:初诊时,只有34.8%的病人符合保乳术的要求,经过4程术前化疗,有70.1%的病人达到了保乳术的标准,其余的29.9%的病人接受了改良的乳腺癌根治术。术前化疗临床有效率达到76.0%(CR4.4%,PR,71.6%),两组病人治疗前的临床特点无差异,保乳术不良反应较乳腺癌根治术少,生存分析显示两组无明显差别。结论:该研究表明,术前化疗可以使部分不可保乳术的病人接受保乳术治疗,并且术前化疗加保乳术与乳腺癌根治术治疗病人预后相当,不良反应减小,术后恢复较好。
Objective: Preoperative chemotherapy can make some patients with advanced breast cancer undergoing breast-conserving surgery. However, this breast-conserving surgery and the efficacy of radical mastectomy is not clear, the purpose of this study is to explore the effect of preoperative chemotherapy and breast cancer radical mastectomy in the treatment of locally advanced breast cancer. Methods: From May 2003 to March 2008, 135 patients with clinical stage II or III breast cancer were enrolled in this study. All patients were evaluated on the method of operation at admission and then underwent 4 cycles of preoperative chemotherapy and reoperation after chemotherapy Evaluation of the way to meet the standard patient breast conservation surgery, other patients underwent radical mastectomy. Record two kinds of surgical patients before and after treatment of clinical indicators and prognosis. Results: Only 34.8% of the patients met the requirements of breast conserving surgery at initial diagnosis. After 4 cycles of preoperative chemotherapy, 70.1% of the patients achieved the standard of breast conserving surgery, and the remaining 29.9% of patients received modified radical mastectomy Surgery. The effective rate of preoperative chemotherapy was 76.0% (CR4.4%, PR, 71.6%). There was no difference in the clinical features between the two groups before treatment, and less adverse reactions in breast-conserving surgery than those in radical mastectomy. Survival analysis showed that both groups had no Obvious difference. Conclusion: The study shows that preoperative chemotherapy can make some patients can not be breast-conserving treatment of breast conserving surgery, and preoperative chemotherapy plus breast-conserving surgery and breast cancer radical treatment of patients with similar prognosis, adverse reactions decreased, postoperative recovery better.