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目的探讨Ⅰ~Ⅱb期乳腺癌行保留乳房的乳腺癌切除术的治疗效果。方法回顾性分析57例Ⅰ~Ⅱb期乳腺癌患者,在接受保留乳房手术、术后辅助放化疗及内分泌治疗后,对照常规行根治切除术组,针对术后局部复发、乳房外形及远处转移进行随访观察。结果研究组患者5年总生存率92.98%,5年无病生存率86.00%。局部复发5例,远处转移3例,转移部位:骨1例,肺1例,肝1例,其中2例死于肿瘤转移。对生存的51例患者进行综合治疗后乳房外观的评价,运用放疗联合中心(JCRT)标准,优、良、中、差分别为22.6%、47.2%、24.5%、5.7%。放、化序贯进行乳房外形优良者占69.5%,放、化疗同时进行则为68.4%,差异无统计学意义(P>0.05)。结论保乳治疗对于早期乳腺癌患者而言安全可行,治疗后有良好的乳房外形。
Objective To investigate the therapeutic effect of breast cancer resection with breast conservatism for stage Ⅰ ~ Ⅱb breast cancer. Methods Retrospective analysis of 57 cases of stage Ⅰ ~ Ⅱb breast cancer patients undergoing breast conserving surgery, adjuvant radiotherapy and chemotherapy and endocrine therapy, control conventional radical resection group, for postoperative local recurrence, breast shape and distant metastasis Follow-up observation. Results The 5-year overall survival rate was 92.98% in the study group and 86.00% in the 5-year disease-free survival rate. Local recurrence in 5 cases, distant metastasis in 3 cases, the transfer site: bone in 1 case, lung in 1 case, liver in 1 case, 2 cases died of tumor metastasis. The evaluation of breast appearance after comprehensive treatment of 51 patients survived was performed. The excellent, good, moderate and poor were 22.6%, 47.2%, 24.5% and 5.7% respectively according to the JCRT criteria. The proportion of patients with excellent breast shape was 69.5%, while the radiotherapy and chemotherapy were 68.4% at the same time. The difference was not statistically significant (P> 0.05). Conclusion Breast-conserving therapy is safe and feasible for patients with early-stage breast cancer and has a good breast appearance after treatment.