Deo S V S, Samaiya A, Shukla N K, Mohanti B K, Raina V, Purkayastha J, Bhutani M, Kar M, Hazarika S, Rath G K
Department of Surgical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Natl Med J India. 2005 Jul-Aug;18(4):178-81.
Breast conservation therapy is a well-established treatment modality for early breast cancer. It is not widely practised in developing countries because of a lack of awareness and treatment facilities, and physician and patient bias. We analysed our experience of breast conservation therapy.
We retrospectively reviewed 102 patients who had undergone breast conservation surgery and axillary dissection for breast cancer. Surgery was followed by 45 Gy of radiation to the whole breast and 15-20 Gy of tumour bed boost. All high risk patients received adjuvant systemic therapy. The disease profile, morbidity and treatment outcome were analysed.
Out of 902 patients, 102 underwent breast conservation therapy (90 had early breast cancer and 12 had locally advanced breast cancer). Only 19.6% of patients with early breast cancer received breast conservation therapy. One-third of the patients had had a prior surgical intervention. The mean tumour size was 2.8 cm, 44% had nodal involvement and 29% were oestrogen- and progesterone-receptor negative. At a mean follow up of 32 months, only 1 patient had local recurrence, and the 5-year projected disease-free and overall survival were 82% and 88%, respectively.
Breast conservation therapy should be offered to suitable breast cancer patients. Strict adherence to protocol-based therapy and active multidisciplinary coordination are crucial for a successful breast conservation therapy programme. Education of the patient as well as the physician population is necessary for increasing the breast conservation therapy rates in India.
保乳治疗是早期乳腺癌一种成熟的治疗方式。由于缺乏认知、治疗设施以及医生和患者的偏见，在发展中国家尚未广泛应用。我们分析了我们在保乳治疗方面的经验。
我们回顾性分析了102例接受保乳手术及腋窝淋巴结清扫术治疗乳腺癌的患者。术后对全乳进行45 Gy的放疗，并对瘤床追加15 - 20 Gy的放疗。所有高危患者均接受辅助全身治疗。分析疾病特征、发病率及治疗结果。
在902例患者中，102例接受了保乳治疗（90例为早期乳腺癌，12例为局部晚期乳腺癌）。早期乳腺癌患者中仅19.6%接受了保乳治疗。三分之一的患者曾接受过手术干预。平均肿瘤大小为2.8 cm，44%有淋巴结转移，29%雌激素和孕激素受体阴性。平均随访32个月时，仅1例患者出现局部复发，预计5年无病生存率和总生存率分别为82%和88%。
应向合适的乳腺癌患者提供保乳治疗。严格遵循基于方案的治疗以及积极的多学科协作对于成功开展保乳治疗项目至关重要。对患者及医生群体进行教育对于提高印度的保乳治疗率是必要的。
