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目的 探讨乳癌外科治疗的策略。方法 回顾性分析 2 5 8例乳癌的临床资料。结果 (1)13 6例Ⅰ～Ⅱ期患者行改良根治术 ,总生存率为 10 0 % ,无复发生存率为 92 .6%。 (2 )保留乳房的乳癌手术 2例 ,1例 (5 0 % )术后 5个月局部复发。 (3 )Ⅲ期乳癌行改良根治术 88例 ,行根治术 2 0例 ,两者的无瘤生存率与总生存率差异无显著性。 (4 )Ⅳ期患者有 5例行根治性手术 ,取得了较好的效果。 (5 )采用特制乳腺刀游离皮瓣和电刀切除 ,并合理清扫腋窝 ,手术输血率为 3 .5 %。局部并发症有术后皮下积血 2 .7% ,皮瓣坏死 7.4% ,皮下积液 18.6% ,患侧肢体水肿 4.3 %。结论 改良根治术是治疗Ⅰ～Ⅲ期乳癌的主要术式 ,乳腺刀和电刀的使用 ,可以减少手术输血 ,缩短手术时间 ;合理的腋窝清扫可以减少患侧肢体水肿的发生。
Objective To explore the strategies of surgical treatment of breast cancer. Methods The clinical data of 258 breast cancers were retrospectively analyzed. Results (1) Of the 166 patients with stage I-II who underwent modified radical mastectomy, the overall survival rate was 100%, and the recurrence-free survival rate was 92.6%. (2) breast cancer surgery in 2 cases, 1 case (50%) local recurrence after 5 months. (3) Modified radical mastectomy for stage III breast cancer was performed in 88 cases and radical resection was performed in 20 cases. There was no significant difference between the disease-free survival rate and overall survival rate. (4) 5 patients with stage IV had radical surgery and achieved good results. (5) The use of special breast knife free flaps and electrocautery resection, and reasonable cleaning of the axilla, surgical transfusion rate was 3.5%. Local complications included postoperative subcutaneous hemorrhage 2.7%, flap necrosis 7.4%, subcutaneous fluid 18.6%, and ipsilateral limb edema 4.3%. Conclusions Modified radical mastectomy is the main method for the treatment of stage I-III breast cancer. The use of breast and electrocautery can reduce blood transfusion and shorten the operation time. Reasonable axillary dissection can reduce the occurrence of edema in affected limbs.