Yamamoto H, Fukuzumi S, Kimura M, Fukutomi T, Nanasawa T, Hirata K, Hirota T
Rinsho Hoshasen. 1989 Apr;34(4):405-18.
Modified mastectomy, which involved removal of the breast, overlying skin and axillary contents but spares the pectoralis muscle, has recently been established as an entirely satisfactory approach for Stage I and Stage II breast carcinoma. In a sequential series of patients, we noted that the traditional mastectomy followed by radiation to axilla and adjacent area failed to confirm the efficacy to support the prevention for local relapse in the past decade. The concepts of adjuvant chemotherapy evolved primarily from clinical trials: CMF and CAMF have been shown to influence favorably the therapy of premenopausal women with positive. nodes. Additional endocrine adjuvant treatment in postmenopausal women with positive nodes was significantly superior to that with CAMF. Immediate breast reconstruction following modified mastectomy or subcutaneous mastectomy was safe, simple, and possible to produce the patient's satisfaction. There was a positive effect on life style and on sexual, social or work relationships. Finally, in recent years, several studies have reported that more conservative treatment, such as partial mastectomy and nodes dissection with postsurgical radiotherapy are as effective as modified mastectomy. Present research will likely continue to modified current treatment as more data are gathered and analyzed clinically and histologically.
改良根治性乳房切除术，即切除乳房、覆盖皮肤和腋窝内容物，但保留胸肌，最近已被确立为治疗Ⅰ期和Ⅱ期乳腺癌完全令人满意的方法。在一系列连续的患者中，我们注意到过去十年中传统的乳房切除术后对腋窝及邻近区域进行放疗并未能证实其对预防局部复发的有效性。辅助化疗的概念主要源于临床试验：CMF和CAMF已被证明对绝经前淋巴结阳性的女性治疗有积极影响。绝经后淋巴结阳性的女性额外进行内分泌辅助治疗明显优于使用CAMF治疗。改良根治性乳房切除术或皮下乳房切除术后立即进行乳房重建是安全、简单的，并且可能会让患者满意。这对生活方式以及性、社交或工作关系有积极影响。最后，近年来，多项研究报告称，更保守的治疗方法，如保乳手术和淋巴结清扫术后放疗，与改良根治性乳房切除术一样有效。随着更多临床和组织学数据的收集与分析，目前的研究可能会继续改进当前的治疗方法。
