Stotter A, Kroll S, McNeese M, Holmes F, Oswald M J, Romsdahl M
Department of Surgery, University of Texas, MD Anderson Cancer Center, Houston 77030.
Eur J Surg Oncol. 1991 Jun;17(3):231-6.
We reviewed the management of 55 cases of loco-regional recurrence after limited surgery and irradiation for breast cancer. Forty-three patients had disease localized to the breast, with axillary involvement in seven. Four had axillary relapse without tumor recurrence in the breast. Eight had breast recurrence extending to involve the chest wall. Mastectomy was used successfully for 41 first recurrences, and seven were controlled by wide excision; 21 of 48 patients also received chemotherapy and/or hormonal manipulation. Diffuse soft-tissue tumor required systemic therapy first, followed by wide excision when possible. Eighty-nine percent of first recurrences were controlled but disease recurred again in eight patients. Overall, 80% of cases were free of loco-regional disease at a median follow-up of 27 months. Reconstructive surgery was valuable for wound closure after wide resections, and for cosmetic procedures. Despite the previous irradiation, surgery complications were acceptable.
我们回顾了55例乳腺癌有限手术及放疗后局部区域复发的治疗情况。43例患者疾病局限于乳腺，其中7例有腋窝受累。4例出现腋窝复发而乳腺无肿瘤复发。8例乳腺复发累及胸壁。41例首次复发成功采用了乳房切除术，7例通过广泛切除得到控制；48例患者中有21例还接受了化疗和/或激素治疗。弥漫性软组织肿瘤首先需要全身治疗，可能的话随后进行广泛切除。89%的首次复发得到控制，但8例患者疾病再次复发。总体而言，在中位随访27个月时，80%的病例无局部区域疾病。重建手术对于广泛切除后的伤口闭合以及美容手术很有价值。尽管之前接受过放疗，但手术并发症仍可接受。
