Department of Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Surg Clin North Am. 2013 Apr;93(2):411-28. doi: 10.1016/j.suc.2012.12.006. Epub 2013 Feb 1.
The twentieth century has witnessed dramatic changes in the surgical management of breast cancer. Herein we focus on the evolution of breast conservation surgery and current surgical trends of lumpectomy, mastectomy and contralateral prophylactic mastectomy. Margin analysis, specimen localization and processing, and the benefits of magnetic resonance imaging remain controversial. Neoadjuvant chemotherapy can offer prognostic information and aid in surgical planning while radiation therapy continues to reduce the risk of local recurrence after breast conserving surgery. Despite these advances, mastectomy remains a popular choice for many women and the use of nipple sparing procedures is increasing. Overall the low rates of local recurrence are attributed to the combination of surgery and targeted adjuvant and radiation therapies.
二十世纪见证了乳腺癌外科治疗的显著变化。在此，我们重点关注保乳手术的发展以及当前的乳房切除术、乳房切除术和预防性对侧乳房切除术的手术趋势。切缘分析、标本定位和处理，以及磁共振成像的益处仍存在争议。新辅助化疗可以提供预后信息并有助于手术计划，而放射治疗继续降低保乳手术后局部复发的风险。尽管取得了这些进展，乳房切除术仍然是许多女性的热门选择，并且保留乳头的手术的应用正在增加。总体而言，低局部复发率归因于手术和靶向辅助治疗与放射治疗的结合。
