Wedgwood K R, Benson E A
General Infirmary at Leeds.
Ann R Coll Surg Engl. 1992 Sep;74(5):314-7.
From 1985 to 1987 148 patients underwent mastectomy for breast cancer, of whom 91 underwent modified radical mastectomy. Of these patients (median age 60 years (range 31-86 years)), 89 have been assessed for early (< 30 days) and late (> 30 days) non-tumour morbidity and mortality. A total of 41 patients had nodal metastases. Adjunctive therapy used was tamoxifen in 70 patients and radiotherapy in 20. Overall, 47 patients (53%) developed a total of 75 complications, and there was one 30-day mortality. Of the patients, 26 developed one complication, 14 had two complications and 7 three complications. Early complications were lymphocoele/seroma (n = 22), wound infection (n = 9) and cardiopulmonary problems (five deep vein thrombosis, two pulmonary embolus (1 death), one myocardial infarct). Late complications were lymphoedema (n = 10), pectoralis major wasting (n = 6), frozen shoulder (n = 7), intercostobrachial neuralgia (n = 4), and a small number of self-limiting wound problems (n = 9). There were two late deaths (myocardial infarcts). Early complications were not related to nodal status, and late complications were related to neither nodal status nor radiotherapy. Significant morbidity is attached to radical surgery for breast cancer. Most complications are minor and self-limiting, but there are a small number of late complications which may affect quality of life.
1985年至1987年期间，148例患者因乳腺癌接受了乳房切除术，其中91例行改良根治性乳房切除术。在这些患者（中位年龄60岁（范围31 - 86岁））中，89例已接受早期（<30天）和晚期（>30天）非肿瘤性发病率和死亡率评估。共有41例患者发生淋巴结转移。辅助治疗中，70例患者使用他莫昔芬，20例接受放疗。总体而言，47例患者（53%）共出现75种并发症，30天内有1例死亡。这些患者中，26例出现1种并发症，14例有2种并发症，7例有3种并发症。早期并发症为淋巴囊肿/血清肿（n = 22）、伤口感染（n = 9）和心肺问题（5例深静脉血栓形成，2例肺栓塞（1例死亡），1例心肌梗死）。晚期并发症为淋巴水肿（n = 10）、胸大肌萎缩（n = 6）、肩周炎（n = 7）、肋间臂神经痛（n = 4）以及少数自限性伤口问题（n = 9）。有2例晚期死亡（心肌梗死）。早期并发症与淋巴结状态无关，晚期并发症与淋巴结状态及放疗均无关。乳腺癌根治手术会带来显著的发病率。大多数并发症为轻度且自限性，但有少数晚期并发症可能影响生活质量。
