Chleboun J O, Gray B N
University Department of Surgery, Royal Perth Hospital, Western Australia.
Aust N Z J Surg. 1987 Sep;57(9):609-13. doi: 10.1111/j.1445-2197.1987.tb01435.x.
A postal survey of all general surgeons in Western Australia was undertaken in order to document their current attitudes towards the management of primary breast cancer. The commonest surgical procedure preferred for stages I and II breast cancer was a modified radical mastectomy, although a substantial number (31%) of surgeons favour breast conserving procedures for primary tumours less than 2 cm in size. Few (3%) surgeons still perform a classical radical or extended radical mastectomy. There is a wide diversity of practices regarding pre-operative investigations and postoperative management. Although many surgeons (68%) use aspiration cytology to determine the histologic nature of breast lumps, the majority (62%) do not use mammography to monitor the contralateral breast. After breast conserving surgery, 60% of surgeons would not refer their patients for adjuvant radiotherapy and over 33% would not favour the use of adjuvant systemic therapy for women with stage II breast cancer. It is concluded that the wide diversity in the pattern of management reflects uncertainty regarding the best approach to this disease.
为了记录西澳大利亚州所有普通外科医生目前对原发性乳腺癌治疗的态度，开展了一项邮政调查。对于I期和II期乳腺癌，最常用的手术方法是改良根治性乳房切除术，不过相当一部分（31%）外科医生赞成对直径小于2厘米的原发性肿瘤采用保乳手术。很少有（3%）外科医生仍在进行经典根治性或扩大根治性乳房切除术。在术前检查和术后管理方面存在广泛的差异。尽管许多外科医生（68%）使用针吸细胞学来确定乳房肿块的组织学性质，但大多数（62%）不使用乳房X线摄影来监测对侧乳房。保乳手术后，60%的外科医生不会将患者转诊接受辅助放疗，超过33%的医生不赞成对II期乳腺癌女性使用辅助性全身治疗。得出的结论是，治疗模式的广泛差异反映了对于该病最佳治疗方法存在不确定性。
