Kurtz J M, Amalric R, Brandone H, Ayme Y, Spitalier J M
Department of Radiation Oncology, University Hospital, Basel, Switzerland.
Cancer. 1988 May 15;61(10):1969-72. doi: 10.1002/1097-0142(19880515)61:10<1969::aid-cncr2820611006>3.0.co;2-o.
Of 1,245 patients treated with breast-conserving surgery and radiotherapy for Stage I and II breast cancers, 118 required a secondary operation subsequently for apparently isolated recurrence in the treated breast. Fifty-two of these 118 patients were selected for salvage treatment with wide excision, with or without axillary dissection, instead of resorting to mastectomy. With a median follow-up of 6 years, the actuarial cancer-specific survival (Kaplan-Meier) after treatment of recurrence was 79% at 5 years and 64% at 10 years. The probability of local control in the treated breast was 79% at 5 years after conservative salvage surgery. Of 12 patients in whom second local or regional recurrences developed, ten could be treated by further surgery. We concluded from this experience that wedge excision represents an adequate alternative to mastectomy in the salvage treatment of isolated breast recurrences that are mobile, 2 cm or smaller in diameter, and without signs of rapid growth.
在1245例接受保乳手术和放疗的I期和II期乳腺癌患者中，有118例随后因治疗的乳房明显出现孤立性复发而需要二次手术。这118例患者中有52例被选择采用广泛切除进行挽救性治疗，可进行或不进行腋窝清扫，而不是进行乳房切除术。中位随访6年，复发治疗后的精算癌症特异性生存率（Kaplan-Meier法）5年时为79%，10年时为64%。保守性挽救手术后5年，治疗乳房的局部控制率为79%。在出现第二次局部或区域复发的12例患者中，有10例可通过进一步手术治疗。我们从该经验中得出结论，在挽救性治疗可移动、直径2厘米或更小且无快速生长迹象的孤立性乳房复发时，楔形切除是乳房切除术的一种适当替代方法。
