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近10余年来,国内各大医院对乳腺癌施行改良根治术者日趋增多。我院自1979～1995年以来,采用各种手术治疗乳腺癌共3798例,其中行改良根治术2300例(占60%)。经随访并总结行改良根治术的各期乳腺癌病人5年和8年的生存率,无病生存率和复发率与行Halsted根治术各期乳腺癌的治疗效果相同。由于对改良根治术的理解不一,各家的手术范围和作法差异颇大。本文主要就保留胸神经的乳腺癌改良根治术Ⅱ式(保留胸大肌,切断胸小肌)介绍我们的体会。 1 乳腺癌改良根治术的适应证①主要适用于临床Ⅰ期和腋窝无明显淋巴结转移的Ⅱ期乳腺癌。②Ⅲ_a期中锁骨下静脉下和胸小肌后
In the past more than 10 years, major domestic hospitals have increasingly improved radical mastectomy for breast cancer. In our hospital since 1979-1995, a total of 3,798 cases of breast cancer have been treated with various types of surgery, among which 2300 cases (60%) have undergone modified radical mastectomy. The 5-year and 8-year survival rates of breast cancer patients undergoing modified radical mastectomy were summarized and followed-up. The disease-free survival rate and recurrence rate were the same as those of Halsted radical mastectomy. Since the understanding of modified radical mastectomy is not the same, the scope and practice of each surgery vary considerably. In this article, we mainly introduce our experience of preserving thoracic nerves with modified radical mastectomy for type II breast cancer (retention of pectoralis major muscle and cutting of pectoralis minor muscle). 1 Indications for modified radical mastectomy for breast cancer 1 is mainly applicable to stage I breast cancer with no significant lymph node metastasis in stage I and axilla. 2 III_a mid subclavian vein and pectoralis minor muscle