Ishida T, Izuo M
2nd Dept. of Surgery, Gunma University School of Medicine.
Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-2):1318-24.
Recurrent breast cancer was classified into the following three groups; I: local skin (chest wall) recurrence including regional lymph nodes (61 cases), II: distant metastasis (93 cases), and III: local plus distant metastasis (33 cases). In this study, the results and evaluation of local forms of treatment for these recurrent breast cancers were analysed. Radiation therapy and surgical resection were mainly used for 61 patients with local recurrence at the primary site (32 skin, 24 lymph node and 5 skin plus lymph node). In most cases, however, various systemic treatments were combined or given consecutively. Response rate to radiation was high. The five-year survival rate after therapy for recurrence was 17% for radiation, 24% for resection with or without combination therapy and 14% for combined or other treatments. Surgical resection produced more long-term surviving patients. The solitary large nodule type of skin recurrence showed better prognosis than multiple small nodules or the diffusely infiltrating type. Recently, wide excision of the anterior breast wall with reconstruction has been performed and this contributes to improving the quality of life and survival. In addition, it is important that local treatment for recurrent breast cancer should be conducted along with a multidisciplinary approach using systemic combination therapy.
I组:包括区域淋巴结的局部皮肤(胸壁)复发(61例),II组:远处转移(93例),III组:局部加远处转移(33例)。在本研究中,分析了这些复发性乳腺癌局部治疗形式的结果和评估。61例原发部位局部复发患者主要采用放射治疗和手术切除(32例皮肤复发、24例淋巴结复发和5例皮肤加淋巴结复发)。然而,在大多数情况下,会联合或连续给予各种全身治疗。放射治疗的缓解率较高。复发治疗后的五年生存率为:放射治疗17%,手术切除联合或不联合治疗为24%,联合或其他治疗为14%。手术切除产生了更多长期存活的患者。孤立性大结节型皮肤复发的预后优于多发小结节型或弥漫浸润型。最近,已开展了前乳房壁广泛切除并重建手术,这有助于提高生活质量和生存率。此外,重要的是复发性乳腺癌的局部治疗应与采用全身联合治疗的多学科方法相结合。