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[乳腺癌——奥勒松医院的诊断与治疗]

[Breast cancer--diagnosis and treatment in a Alesund hospital].

作者信息

Opsahl Else Marie, Westre Bjørn, Samset Jon Helge, Olafsson Sverrir, Michelsen Kåre, Varhaug Jan Erik

机构信息

Seksjon for bryst- og endokrinkirurgi, Kirurgisk avdeling, Alesund sjukehus, 6026 Alesund, Norway.

出版信息

Tidsskr Nor Laegeforen. 2010 Apr 8;130(7):724-8. doi: 10.4045/tidsskr.09.0155.

Abstract

BACKGROUND

We wanted to check if our routines for diagnosing and treating primary operable breast cancer and ductal carcinoma in situ were concordant with national guidelines and quality standards.

MATERIAL AND METHODS

Data were retrospectively collected from medical journals for all relevant patients operated at Alesund Hospital, Norway from 1.11.02 to 1.05.08.

RESULTS

487 breasts were operated in 478 patients. A triple-diagnostic approach (mammography/ultrasound, clinical examination and biopsy) was used in 98 % of patients and ultrasound-guided core-needle-biopsy in 86 %. For 82 % of patients one visit in an out-patient-department was enough to conclude with a malignant diagnosis. A sentinel node biopsy was taken for 378 of 457 (83 %) patients operated in the axilla; a sentinel node was found in 93 % of them. Three (median) sentinel nodes were removed (spread in the range 1 - 12). 51 % of patients had breast-conserving surgery. From diagnosis of cancer to completion of all surgical procedures, 57 patients (12 %) had two operations, three (0.6 %) had three operations (in the breast and axilla), and 89 % of patients had completed all surgery within three weeks.13 % of patients had postoperative complications. After axillary lymph-node dissection, 20 % of patients had lymph-oedema/shoulder/arm pain. Three patients had ipsilateral relapse in the breast or thoracic wall. None had axillary relapse after sentinel-node biopsy. The median observation time was 26 months (0 - 66 months).

INTERPRETATION

The results of diagnosis and treatment in our hospital are in good accordance with our national guidelines and quality standards.

摘要

背景

我们想要检查我们诊断和治疗原发性可手术乳腺癌及导管原位癌的流程是否符合国家指南和质量标准。

材料与方法

回顾性收集了挪威奥勒松医院在2002年11月1日至2008年5月1日期间接受手术的所有相关患者的医学期刊数据。

结果

478例患者共487个乳房接受了手术。98%的患者采用了三联诊断方法(乳房X线摄影/超声、临床检查和活检),86%的患者采用了超声引导下的粗针活检。82%的患者在门诊就诊一次就足以确诊为恶性肿瘤。457例腋窝手术患者中有378例(83%)进行了前哨淋巴结活检;其中93%发现了前哨淋巴结。切除了3个(中位数)前哨淋巴结(范围为1 - 12个)。51%的患者接受了保乳手术。从癌症诊断到所有手术程序完成,57例患者(12%)进行了两次手术,3例患者(0.6%)进行了三次手术(乳房和腋窝),89%的患者在三周内完成了所有手术。13%的患者有术后并发症。腋窝淋巴结清扫术后,20%的患者出现淋巴水肿/肩部/手臂疼痛。3例患者在乳房或胸壁出现同侧复发。前哨淋巴结活检后无一例出现腋窝复发。中位观察时间为26个月(0 - 66个月)。

解读

我们医院的诊断和治疗结果与国家指南和质量标准高度相符。

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