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[乳腺癌新辅助化疗有效后保乳手术的病理表现及可行性]

[Pathological manifestation and feasibility of conservative breast surgery after effective neoadjuvant chemotherapy for breast cancer].

作者信息

Liu Chun-Ping, Shi Lan, Li Zhi

机构信息

Department of Breast and Thyroid Surgery, Union Hospital, Huazhong University of Science and Technology, Wuhan 430022, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Sep 15;46(18):1394-6.

Abstract

OBJECTIVE

To investigate the pathological manifestation of the lesion as well as the feasibility of conservative breast surgery after neoadjuvant chemotherapy of patients with locally advanced breast cancer.

METHODS

Clinic data of the 46 patients treated by neoadjuvant chemotherapy effectively and surgical procedures from June 2003 to August 2007 were analyzed. All the patients were female, aged from 28 to 65 years old with a mean of 46.3 years old. The diameter of neoplasm was 7 to 13 cm. All the patients had been treated by neoadjuvant chemotherapy effectively and received modified radical mastectomy or Halsted radical mastectomy. The specimen slices were cut from 6 different directions taking the residual cancerous lesion as the center.

RESULTS

Nineteen patients (41.3%) were concentrating contracted, with complete remission in 6 patients (31.6%) and residual focus in peripheral zone in 13 patients (68.4%). Twenty-seven patients (58.7%) responded in a sifter-like pattern.

CONCLUSION

For most patients with locally advanced breast cancer treated by neoadjuvant chemotherapy effectively, their pathologic features are not up to the conservative breast surgery criterion, conservative breast surgery should be cautiously considered.

摘要

目的

探讨局部晚期乳腺癌患者新辅助化疗后病变的病理表现以及保乳手术的可行性。

方法

分析2003年6月至2007年8月期间46例接受有效新辅助化疗及手术治疗患者的临床资料。所有患者均为女性,年龄28至65岁,平均46.3岁。肿瘤直径7至13厘米。所有患者均接受了有效新辅助化疗,并接受了改良根治性乳房切除术或Halsted根治性乳房切除术。以残留癌灶为中心,从6个不同方向切取标本切片。

结果

19例(41.3%)呈集中收缩,6例(31.6%)完全缓解,13例(68.4%)外周区有残留病灶。27例(58.7%)呈筛状反应。

结论

对于大多数接受有效新辅助化疗的局部晚期乳腺癌患者,其病理特征未达保乳手术标准,应谨慎考虑保乳手术。

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