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作者对101例早期乳癌用同样的保守手术(象限切除加腋清扫)后评价了放疗对乳房美容的影响。61例术后对剩余乳房外照射(50+10Gy),40例仅作保守术。乳房美容的评价是连续在医院内观察4个月,此后在2年中完成评价,以确保急性放射反应已稳定。手术技术标准化,象限切除肿瘤,切缘至少距肿瘤缘2cm,腋清扫至Ⅰ、Ⅱ和Ⅲ级水平。当肿瘤在外上象限,腋清扫切口则与肿瘤切口相连,否则则分开切口。术后4～6周开始用6MV直线加速器或~(60)钴以对穿切线野照射全乳房与邻近组织,野长16～20cm,宽8～12cm,为保证剂量均匀用了楔形过滤板。每次2Gy,共5oGy/5周,后用常压或10MV电子线在1周内对乳房疤痕处补充10Gy。客观评定乳房
The authors evaluated the effect of radiotherapy on breast-beautification in 101 patients with early-stage breast cancer who underwent the same conservative surgery (quadrantectomy plus fistula dissection). Sixty-one patients had residual breast irradiation (50+10 Gy) after surgery, and 40 cases were only conservative. The assessment of breast beautification was continuously observed in the hospital for 4 months, and then evaluated in 2 years to ensure that the acute radiation response was stabilized. The surgical technique was standardized. The tumor was resected in the quadrant. The margin was at least 2 cm from the tumor margin and the fistula was swept to level I, II, and III. When the tumor is in the upper quadrant, the fistula-cleaved incision is connected to the tumor incision, otherwise the incision is divided. After 4 to 6 weeks, 6 MV linear accelerators or ~(60) cobalt were used to irradiate the tangential field to the entire breast and adjacent tissues. The length of the field was 16-20 cm and the width was 8-12 cm. A wedge-shaped filter plate was used to ensure uniform dose. Each time 2Gy, a total of 5oGy for 5 weeks, 10Gy of breast scars were supplemented with normal pressure or 10MV electron wire within 1 week. Objective assessment of breast