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目的介绍乳腺癌保留乳房治疗的手术模式、放射治疗技术、放疗并发症及美容效果。方法１９８５年８月至１９９６年６月共６５例女性乳腺癌病人接受了保留乳房术加术后根治性放疗，其中，Ⅰ期２９例，Ⅱ期３４例，Ⅲ期２例，肿瘤位于外上象限者５２例，其他象限者１３例。手术模式为乳房肿瘤扩大切除术加腋淋巴结清扫术。全部病人均于术后２个月内接受根治性放疗，各野的中位剂量分别为内乳ＤＴ５３．２Ｇｙ、锁上ＤＴ５５．４Ｇｙ、全乳切线ＤＴ４９．２Ｇｙ、瘤床追加ＤＴ１４．６Ｇｙ。结果病人的３年和５年生存率分别为９３．６％、９１．７％；出现急性放射反应者１３例，占２０％；出现放射性肺炎／肺纤维化者４例，发生率６％；出现乳房／胸壁纤维化者２例。治疗后美容效果医患均满意者占９２．３％。结论早期乳腺癌保留乳房加术后根治性放疗与根治性手术疗效相同，只要选择病例恰当并掌握好手术模式和放疗技术，其手术和放射并发症的发生率是可以接受的，而且具有良好的美容效果。
Objective To introduce the surgical model of breast cancer preservation, radiation therapy, radiotherapy complications and cosmetic results. Methods From August 1985 to June 1996, a total of 65 women with breast cancer received radical mastectomy and radical radiotherapy. Among them, 29 patients were in stage I, 34 in stage II, and 2 in stage III. The tumors were located on the external There were 52 cases in quadrants and 13 cases in other quadrants. Surgical model for extended breast tumor resection plus axillary lymph node dissection. All patients received radical radiotherapy within 2 months after surgery. The median doses of the fields were DT53.2Gy for internal milk, DT55.4Gy for lock, DT49.2Gy for whole milk tangent, and DT14.6Gy for tumor bed. Results The 3-year and 5-year survival rates of the patients were 93.6% and 91.7%, respectively; there were 13 cases of acute radiation reactions, accounting for 20%; 4 cases of radiation pneumonitis/lung fibrosis occurred, and the incidence rate was 6%; There were 2 cases of breast/chest wall fibrosis. After treatment, doctors and patients who were satisfied with cosmetic results accounted for 92.3%. CONCLUSION: The curative effect of radical mastectomy plus radical radiotherapy for early breast cancer is the same as for radical surgery. As long as the appropriate case is selected and the operation mode and radiotherapy technique are well-controlled, the incidence of surgical and radiation complications is acceptable, and it has good results. Cosmetic effect.