Axelsson C K, Blichert-Toft M
Surgical Departments K, Vejle Hospital, Denmark.
Acta Oncol. 1988;27(6A):605-9. doi: 10.3109/02841868809091759.
From 1977 to 1982 a total of 2,935 women with breast cancer fulfilled the criteria for inclusion in the low-risk protocol of the Danish Breast Cancer Cooperative Group, DBCG 77-A. The operation performed was a total mastectomy with axillary dissection slightly modified according to Cady. Postoperatively the patients were examined clinically and by chest radiography with intervals for ten years or until recurrence. With a median observation time of seven years loco-regional recurrence appeared in 409 patients (13.9%): chest wall 9.3%, axilla 3.7%. Half of the recurrences were diagnosed within two years postoperatively. Metastases appeared in 396 patients (13.5%), mainly in bones and lungs; 96 patients (23.5%) with loco-regional recurrence and 174 (43.9%) with distant metastases died from breast cancer during the observation time. Life-table analyses of recurrence-free survival (61.7%) and survival (75.4%) are presented. The results of the treatment are in accordance with reports in the literature, but a straightforward comparison is impossible on account of a huge variation in surgical and postsurgical treatment. Finally, the surgical technique in the participating departments in this nation-wide study was evaluated. A high grade of uniformity with respect to loco-regional recurrences was found.
1977年至1982年期间，共有2935例乳腺癌女性患者符合丹麦乳腺癌协作组（DBCG 77-A）低风险方案的纳入标准。所施行的手术为全乳切除术，并根据卡迪（Cady）的方法对腋窝清扫术稍作改良。术后对患者进行临床检查及胸部X线检查，为期十年或直至复发。中位观察时间为七年，409例患者（13.9%）出现局部区域复发：胸壁复发率为9.3%，腋窝复发率为3.7%。半数复发在术后两年内被诊断出来。396例患者（13.5%）出现转移，主要转移至骨骼和肺部；96例（23.5%）局部区域复发患者以及174例（43.9%）远处转移患者在观察期内因乳腺癌死亡。文中给出了无复发生存率（61.7%）和生存率（75.4%）的生命表分析结果。治疗结果与文献报道一致，但由于手术及术后治疗存在巨大差异，无法进行直接比较。最后，对参与这项全国性研究的各科室的手术技术进行了评估。结果发现，局部区域复发方面具有高度的一致性。
