Sakorafas G H, Tsiotou A G
Department of Surgery, 251 Hellenic Air Force (HAF) General Hospital, Athens, Greece.
Eur J Surg. 2000 Nov;166(11):835-46. doi: 10.1080/110241500447209.
Breast conservation, comprising limited excision of the breast and axillary lymphadenectomy followed by irradiation, yields survival equal to mastectomy with the advantage of preservation of the breast for properly selected patients. When breast conservation therapy is competently done it achieves highly satisfactory cosmetic results and acceptably low rates of local recurrence. However, numerous controversies surround the selection criteria, the relative importance of some of them, and the treatment. Four critical elements in selecting patients for breast conservation therapy are: history and physical examination, careful mammographic evaluation, histological assessment of the resected specimen, and assessment of the patient's needs and expectations. Today, it is estimated that breast conservation can be recommended to 50%-75% of all women with operable breast cancer. However, this treatment is not widely used. In this article we review the generally accepted principles and controversies about the selection of patients for breast conservation.
保乳治疗包括对乳房进行有限切除及腋窝淋巴结清扫，随后进行放疗，其生存率与乳房切除术相当，对于合适的患者具有保留乳房的优势。当保乳治疗操作得当，可取得非常令人满意的美容效果以及可接受的低局部复发率。然而，围绕选择标准、其中一些标准的相对重要性以及治疗方法存在诸多争议。选择保乳治疗患者的四个关键要素是：病史和体格检查、仔细的乳房X线评估、切除标本的组织学评估以及对患者需求和期望的评估。如今，估计可向50% - 75%的可手术乳腺癌女性推荐保乳治疗。然而，这种治疗方法并未得到广泛应用。在本文中，我们回顾了关于选择保乳治疗患者的普遍接受的原则和争议。
