目的:探讨合适的乳腺癌保留乳房手术切除范围。方法:对104例乳腺癌根治手术患者的切除标本进行观察研究。每一患者标本分为“癌肿区”、“近癌区”和“远癌区”。以肿瘤切除活检标本或肉眼可见肿瘤及其周围0.5cm区域为“癌肿区”;“癌肿区”边缘向外1cm～3cm区域为“近癌区”;3cm～5cm区域为“远癌区”。对三个区域乳腺组织非典型增生和c-erbB-2、p53基因蛋白异常表达发生情况分别进行研究。结果:104例乳腺癌手术标本中,“近癌区”和“远癌区”发生非典型增生率分别为56.7%、32.7%,其中Ⅱ、Ⅲ级非典型增生率“近癌区”明显高于“远癌区”。49例c-erbB-2阳性乳腺癌中,“近癌区”亦发现有c-erbB-2阳性表达者26例(53.6%),“远癌区”阳性表达者8例(16.3%)。两组比较均P<0.01。25例p53阳性者中,“近癌区”及“远癌区”检测均阴性。结论:提示在行保留乳房手术时,一并切除近癌组织是必要的。 Objective: To explore the appropriate breast conserving breast surgery range. Methods: 104 cases of radical resection of breast cancer patients were observed. Each patient’s specimen is divided into “cancer area”, “near cancer area” and “far cancer area”. Tumor resection biopsy specimens or the naked eye can see the tumor and the surrounding 0.5cm area for the “cancer area”; “cancer area” edge 1cm ~ 3cm out of the area for the “near cancer area”; 3cm ~ 5cm area for the “far cancer area ”. The three regions of atypical hyperplasia of breast tissue and c-erbB-2, p53 gene protein abnormal expression were studied. Results: Among the 104 breast cancer specimens, the rates of atypical hyperplasia were 56.7% and 32.7% respectively in the “near-cancer area” and “far-field area”, of which the grade Ⅱ and Ⅲ atypical hyperplasia rates were significantly higher In the “far cancer area.” Of the 49 cases of c-erbB-2 positive breast cancer, 26 cases (53.6%) were positive for c-erbB-2 positive expression and 8 cases (16.3%) were positive for distant cancer. The two groups were compared P <0.01.25 p53 positive, “near cancer area” and “far cancer area” test were negative. CONCLUSION: It is suggested that resection of near-cancer tissue is necessary when breast-conserving surgery is performed.