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[保乳治疗的经验与逻辑]

[Experience and logic of breast conservation therapy].

作者信息

Kondo M, Amemiya A

出版信息

Rinsho Hoshasen. 1989 Apr;34(4):463-70.

PMID:2545954
Abstract

One hundred patients with an operable breast cancer were treated with intent of breast conservation in six years. Five patients developed contralateral breast cancers synchronously or metachronously. Therefore, a total of 105 breasts were treated. T1 tumors were seen in 55 breasts, T2 tumors in 45, and T3 in 5. Breast conservation were possible for 95 breasts: 52 with T1 tumors,+ 41 with T2, and 2 with T3. No patients have relapsed yet. There is great concern or even fear for breast conservation among surgeons. We discuss about several issues concerning surgical margin, intraductal carcinoma, multicentricity, radiation injuries including carcinogenesis, racial difference of curability, etc., and try to establish the logic of doing or not-doing this treatment which has been proven by randomized clinical controlled trials. Reasons for conservative attitude expressed by the surgeons are irrelevant or illogical. We conclude that it now is the responsibility for the surgeons to prove survival benefit if they would continue to perform mutilating surgery such as Halsted operation.

摘要

六年里,100例可手术乳腺癌患者接受了保乳治疗。5例患者同时或异时发生对侧乳腺癌。因此,总共治疗了105个乳房。其中55个乳房为T1期肿瘤,45个为T2期,5个为T3期。95个乳房可行保乳治疗:52个T1期肿瘤乳房,41个T2期,2个T3期。尚无患者复发。外科医生对保乳治疗存在极大担忧甚至恐惧。我们讨论了有关手术切缘、导管内癌、多中心性、包括致癌作用在内的放射损伤、治愈率的种族差异等几个问题,并试图确立这种已被随机临床对照试验证实的治疗方法的实施逻辑。外科医生持保守态度的原因是不相关或不合逻辑的。我们得出结论,如果外科医生继续进行如Halsted手术这样的致残性手术,那么他们有责任证明其对生存有益。

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