前期乳腺癌能活40年 保乳保腋窝手术医治T1期乳腺癌86例剖析

史立波　王伟　于德海

[摘要]意图 调查T1期乳腺癌行保乳保腋窝手术的医治作用。办法 回忆性剖析2009年8月～2014年10月我院收治的86例行保乳保腋窝手术的T1期乳腺癌患者的临床材料，调查患者的手术并发症、术后乳房美学作用及肿瘤巨细与预后的联系。成果 86例患者的手术切断均Ⅰ期愈合，均无患肢淋巴水肿发作，术后乳房美学作用满意度为96.5%（83/86）。肿瘤直径≤1 cm组共40例（1组），前哨淋巴结阳性率为0（0/40）；1 cm<肿瘤直径≤2 cm组共46例（2组），前哨淋巴结阳性率为15.2%（7/46），两组患者的前哨淋巴结阳性率比较差异有统计学含义（P<0.05）。1组生存率略高于2组，但差异无统计学含义（P<0.05）。悉数病例均随访，随访时刻24～87个月，中位随访时刻为50个月，均无复发及搬运。定论 保乳保腋窝手术医治T1期乳腺癌，作用好，并发症少，值得临床使用。

[关键词]T1期乳腺癌；保乳保腋窝手术；前哨淋巴结；美学作用

[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-4721（2017）03（b）-0069-04

[Abstract]Objective The observe the therapeutic effect of breast and axillary reservation operation for stage T1 breast cancer.Methods The clinical data of 86 patients with stage T1 breast cancer who underwent breast and axillary reservation operation treated in our hospital form August 2009 to October 2014 were retrospectively analysed.The postoperative complications，the effect of breast aesthetics and the relationship between tumor size and prognosis were analyzed.Results Surgical incision in 86 patients with stage Ⅰ healing，no limb lymphedema，postoperative satisfaction effects on aesthetics of breast was 96.5% （83/86）.The tumor diameter less than 1 cm were 40 cases （group 1），the positive rate of sentinel lymph nodes was 0 （0/40）；tumor diameter more than 1 cm and less than 2 cm were 46 cases （group 2），the positive rate of sentinel lymph nodes was 15.2% （7/46）.There was significant difference in the positive rate of sentinel lymph node between two groups （P<0.05）.Further survival analysis showed that the survival rate of the group 1 was slightly higher than that of group 2，but the difference was not statistically significant （P<0.05）.All cases were followed up for 24-87 months，the median follow-up time of 50 months，and no recurrence and metastasis were found.Conclusion Breast and axillary reservation operation in the treatment of stage T1 breast cancer has good effect and few complications，which is worthy of clinical application.

[Key words]Stage T1 breast cancer；Breast and axillary reservation operation；Sentinel lymph node；Aesthetic effect

近些年來我国前期乳腺癌，尤其是T1期乳腺癌（肿瘤直径≤2.0 cm）的发病率显着升高，这首要归功于人们自我保健认识的进步和临床查看技能的不断改进[1-2]。现在保存乳房手术是医治T1期乳腺癌的首要手术办法，并为广阔医界同仁认可[3-4]。关于保存乳房手术乳房残缺以及腋窝淋巴结的处理，现在仍有争议。本文通过剖析本院收治的86例行保乳保腋窝手术医治的T1期乳腺癌患者的临床材料，调查其临床效果及安全性，现报导如下。

1材料与办法

1.1一般材料

挑选2009年8月～2014年10月本院收治的86例T1期乳腺癌而且成功施行了保乳保腋窝手术患者的临床材料，一切患者均契合以下保乳手术指征：①肿瘤直径≤2.0 cm；②肿瘤距乳晕边际≥2.0 cm；③乳腺钼靶扫除充满恶性钙化，乳腺彩超或乳腺MRI扫除乳房内多发癌灶；④乳房有恰当的体积，一般 >200 ml；⑤术后有条件进行放疗；⑥临床评价腋窝淋巴结阴性；⑦在外炎性乳腺癌及妊娠哺乳期乳腺癌；⑧患者自己及家族有激烈的保乳要求。本研讨通过医院医学道德委员会讨论通过，一切患者均签署手术知情同意书。