Unit of Breast Surgery, Department of General Surgery, Norfolk & Norwich Hospital NHS Trust, Norwich, United Kingdom.
Breast J. 2013 May-Jun;19(3):310-8. doi: 10.1111/tbj.12105.
Patients with isolated ipsilateral breast cancer recurrence face completion mastectomy in the majority of cases. Selected patients may derive good outcomes from repeat breast conservation surgery and indeed repeat irradiation may be employed using one of many different modalities. Tumor biology rather than salvage surgery method is likely to influence outcome. Patients with isolated breast tumor recurrence are treated in the majority of cases with completion mastectomy, when for selected patients there exists little evidence that more radical surgery provides better outcomes in terms of further recurrence and overall survival, than repeated breast conserving surgery. Literature search identifying articles addressing the issue of repeat breast conserving surgery for ipsilateral breast tumor recurrence, and repeat radiotherapy(search terms include: repeat breast conserving surgery, salvage mastectomy, salvage breast conserving surgery,salvage radiotherapy, reirradiation). Thirty-five articles discussed the outcomes of repeat breast conserving surgery versus salvage mastectomy, methods of repeat breast irradiation, repeat sentinel lymph node biopsy and related factors. Repeat breast conserving surgery may represent a safe and feasible treatment method for isolated ipsilateral breast tumor recurrence.
对于孤立性同侧乳腺癌复发的患者，大多数情况下需要进行全乳切除术。部分患者通过重复保乳手术可能获得较好的结果，事实上，重复放疗可采用多种不同的方式。肿瘤生物学而非挽救性手术方法可能影响治疗效果。大多数孤立性乳腺癌局部复发的患者采用全乳切除术治疗，而对于少数患者，几乎没有证据表明更激进的手术在进一步复发和总生存方面优于重复保乳手术。文献检索确定了一些探讨同侧乳房肿瘤复发重复保乳手术和重复放疗问题的文章（检索词包括：重复保乳手术、挽救性乳房切除术、挽救性保乳手术、挽救性放疗、再放疗）。有 35 篇文章讨论了重复保乳手术与挽救性乳房切除术、重复乳房放疗、重复前哨淋巴结活检和相关因素的结果。重复保乳手术可能是治疗孤立性同侧乳房肿瘤复发的一种安全可行的方法。
