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目的总结保乳手术治疗早期乳腺癌的临床经验及疗效观察。方法本院2003～2006年收治女性乳腺癌248例,选择临床0～IIa期、非乳晕区单发肿瘤66例施行保乳手术。采用肿块局部广泛切除加腋淋巴结清扫或象限切除加腋淋巴结清扫术治疗,术后行辅助放疗、化疗及内分泌治疗。结果66例手术全部成功,无并发症发生。总保乳率22.61%(66/248);美容满意率达93.61%。平均随访78个月,随访率78.8%(52/66例)。局部复发率1.92%(1/52例),腋淋巴结复发率3.84%(2/52例),复发时间为术后3年零2个月;远处转移率1.92%(1/52例),术后4年1例肺转移,1例肝转移;随访期中,死亡2例,1例死因为心肌梗死,1例为肺转移;5年无病生存率82.69%(42/52例),总生存率96.15%(50/52例)。结论早期乳腺癌患者接受保乳手术治疗可以取得满意的临床和美容效果。
Objective To summarize the clinical experience and curative effect of breast conserving surgery for early breast cancer. Methods The hospital from 2003 to 2006 admitted 248 cases of female breast cancer, select the clinical 0 ~ IIa period, non-areola area single tumor of 66 cases of breast-conserving surgery. Local mass excision plus axillary lymph node dissection or quadrant resection plus axillary lymph node dissection were performed, followed by adjuvant radiotherapy, chemotherapy and endocrine therapy. Results All the 66 surgeries were successful without complication. The total protection rate of 22.61% (66/248); beauty satisfaction rate of 93.61%. The average follow-up of 78 months, the follow-up rate was 78.8% (52/66 cases). The local recurrence rate was 1.92% (1/52), the axillary lymph node recurrence rate was 3.84% (2/52 cases), the recurrence time was 3 years and 2 months after operation. The distant metastasis rate was 1.92% (1/52) One case had lung metastases and one case had liver metastases 4 years after operation. During the follow-up period, 2 patients died of myocardial infarction and 1 patient died of lung metastases. The 5-year disease-free survival rate was 82.69% (42/52 patients) The survival rate was 96.15% (50/52 cases). Conclusion Breast-conserving surgery in patients with early breast cancer can achieve satisfactory clinical and cosmetic results.