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目的 :探讨手术、化疗和内分泌治疗方式的改变对乳腺癌预后的影响。方法 :1976～ 1993年住院的女性乳腺癌患者 2 311例 ,统计分析术式演变趋势和不同术式腋窝淋巴结清除的程度。以规范辅助化疗和内分泌治疗的1985年、1986年为界 ,分段比较各期患者所占比例及其 5年和 10年生存率。结果 :1984年以前根治术为乳腺癌治疗的主要术式 ,其后改良根治术成为主导术式。该 2种术式腋窝淋巴结平均清除数量相同。 1986年以后 、 期患者所占的比例均有显著提高 ,而 期、 期和总体患者的 5年生存率亦均有显著提高。 、 、 期和总体患者的 10年生存率均有提高趋势 ,但无统计学意义。结论 :改良根治术可以获得与根治术相同的腋窝淋巴结清除效果。规范应用全身性治疗措施是提高乳腺癌患者长期生存率的重要环节。
Objective: To investigate the effect of surgery, chemotherapy, and endocrine therapy on the prognosis of breast cancer. METHODS: A total of 2 311 women with breast cancer who were hospitalized from 1976 to 1993 underwent statistical analysis of the evolution of the surgical technique and the degree of axillary lymph node dissection. In 1985 and 1986, the use of standard adjuvant chemotherapy and endocrine therapy was divided into sections. The proportion of patients in each phase and their 5-year and 10-year survival rates were compared. RESULTS: Before 1984, radical mastectomy was the main surgical procedure for breast cancer. Later, modified radical mastectomy became the dominant surgical procedure. The average removal of axillary lymph nodes was the same in both surgical procedures. The proportion of patients after 1986 has significantly increased, and the 5-year survival rate of patients at the end of the period and the overall period has also significantly increased. The 10-year survival rate of patients, patients, and overall patients increased, but it was not statistically significant. Conclusion: Modified radical mastectomy can achieve the same axillary lymph node clearance effect as radical mastectomy. Regulating the use of systemic treatment measures is an important part of improving the long-term survival rate of breast cancer patients.