Noguchi M, Miyazaki I
Operation Center, Kanazawa University Hospital, Japan.
Int Surg. 1990 Jan-Mar;75(1):8-14.
The management of breast cancer is highly controversial. Various operations have been performed in different hospitals. This controversy may arise from an incomplete knowledge of the biology of breast cancer. At present, surgeons are highly recommended to perform an adequate surgery which gives the ultimate in local control, does not compromise the chance of cure and gives the best cosmetic and aesthetic results. Recently, the choice of conservative surgery with aggressive radiation therapy versus more adequate surgery, total mastectomy and axillary dissection, is a major controversial problem for primary treatment of operable breast cancer. However, to avoid local recurrence with attendant worry for the patient, conservative surgery should only be indicated for a select group of patients with early breast cancer. At present, there is little doubt that mastectomy and regional lymph node dissection are the most beneficial methods of treatment in all other patients. So, adequate surgery and breast reconstruction are more preferably recommended for ensuring local control and for providing a better psychological impact.
乳腺癌的治疗极具争议性。不同医院开展了各种手术。这种争议可能源于对乳腺癌生物学认识的不完整。目前，强烈建议外科医生进行充分的手术，以实现最佳的局部控制，不影响治愈机会，并获得最佳的美容和美学效果。最近，对于可手术乳腺癌的初始治疗，选择保乳手术加积极放疗与更充分的手术（全乳切除和腋窝清扫）相比，是一个主要的争议问题。然而，为避免局部复发给患者带来担忧，保乳手术仅适用于一小部分早期乳腺癌患者。目前，毫无疑问，乳房切除术和区域淋巴结清扫是所有其他患者最有益的治疗方法。因此，更推荐进行充分的手术和乳房重建，以确保局部控制并产生更好的心理影响。
