Borup Christensen S, Lundgren E
Department of Surgery, Ostersund Hospital, Sweden.
Acta Chir Scand. 1989 Oct;155(10):515-9.
One hundred women with operable breast cancer were randomized to two equal groups. In group A the aim was to remove all fat tissue in the axilla. In group B suspectedly pathologic nodes were removed, and if no nodes were palpable the lower half of the axillary fat was excised. Irrespective of this grouping, partial mastectomy was generally performed for T1 tumour (17 in each group) and mastectomy for T2 tumour (33 in each group). Also irrespective of A and B grouping, radiotherapy including the axilla was given after partial mastectomy, and to women under 70 with T2 tumour and/or lymph-node secondaries. Arm volume and shoulder mobility were measured before and 3, 6 and 12 months after surgery. Arm oedema (greater than or equal to 10% volume increase) was found in 14 group A patients, but none in group B. Twelve of the 14 patients with arm oedema had been irradiated. Subjective sensation of arm swelling in the absence of an objectively measurable increase in arm volume was also more common after axillary dissection plus irradiation than after the other forms of treatment. Impairment of shoulder mobility was more frequent after axillary irradiation.
100名患有可手术乳腺癌的女性被随机分为两组。A组的目的是切除腋窝所有脂肪组织。B组切除可疑病理性淋巴结，若未触及淋巴结，则切除腋窝下半部分脂肪。无论分组情况如何，T1期肿瘤（每组17例）一般行部分乳房切除术，T2期肿瘤（每组33例）行乳房切除术。同样与A、B组分组无关，部分乳房切除术后对腋窝进行放疗，对70岁以下T2期肿瘤和/或有淋巴结转移的女性进行放疗。在手术前以及术后3个月、6个月和12个月测量手臂体积和肩部活动度。A组14例患者出现手臂水肿（体积增加大于或等于10%），而B组无此情况。14例手臂水肿患者中有12例接受过放疗。在腋窝清扫加放疗后，手臂在无客观可测量体积增加情况下的主观肿胀感也比其他治疗方式更为常见。腋窝放疗后肩部活动度受损更为频繁。
