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近20年来已使用术前化疗以控制或缩小局部晚期乳腺癌病灶,以俾采用较保守性术式以替代习用的根治性切除.作者自1988年～1990年对226例≥3cm的乳腺癌进行了上述方案处理,其中肿块3.0～4.0cm141例、4.1～5.cm 56例和>5.0cm29例,年龄均在65岁以下,中位值年龄为49岁,临床病理分期为T_2N_048例、T_2N_1 149例、T_3N_0 6例和T_3N_1 23例.术前给环磷酰胺500mg/m~2、氟尿嘧啶500mg/m~2和阿霉素50mg/m~2(第一天),氟尿嘧啶500mg/m~2(第八天),重复3～4次;或用氯甲喋呤40mg/m~2替代阿霉素等,220例完成上述治疗方案.重复检查,如肿瘤明显缩小,则行乳腺象限连同肿块切除,否则仍作乳腺癌根治术,全部病例均作腋淋巴结清扫术,其手术例数如表一所示:表一 化疗后肿块大小与手术术式
In the past 20 years, preoperative chemotherapy has been used to control or reduce local advanced breast cancer lesions, and conservative methods have been used instead of conventional radical resection. The authors performed 226 breast cancer cases ≥3cm from 1988 to 1990. The above protocol was used to treat the patients with lumps of 3.0 to 4.0 cm in 141 cases, 4.1 to 5. cm in 56 cases, and >5.0 cm in 29 cases. The ages were all under 65 years old, the median age was 49 years old, and the clinical pathological stage was T_2N_048 cases, T_2N_1 149 Cases, T_3N_0 6 cases and T_3N_1 23 cases. Preoperatively to cyclophosphamide 500mg/m 2, fluorouracil 500mg/m 2 and doxorubicin 50mg/m 2 (the first day), fluorouracil 500mg/m 2 ( Eighth day), repeat 3 to 4 times; or replace doxorubicin with 40 mg/m~2, etc. 220 cases complete the above treatment plan. Repeated examination, if the tumor shrinks significantly, the mammary gland with mastectomy Otherwise, radical mastectomy was still performed. All cases were treated with axillary lymph node dissection. The number of operations was as shown in Table 1: Table 1 The size of the tumor after chemotherapy and the surgical procedure