Clarke D, Martinez A, Cox R S
Int J Radiat Oncol Biol Phys. 1983 Dec;9(12):1807-13. doi: 10.1016/0360-3016(83)90348-6.
Between May, 1973 and December, 1980, 78 Stage I and II breast carcinomas in 76 patients were treated by biopsy and radiotherapy with curative intent. With a maximum follow-up of 10 years, a minimum of 2 1/2 years and a median follow-up of 3 1/2 years, a loco-regional control rate of 97% was obtained. Cosmetic results and treatment complications were studied. Patient characteristics, tumor size, excisional biopsy technique, axillary staging procedure and radiotherapy techniques were analyzed and all found to be important factors affecting cosmesis and complications. The most common complications included transient breast edema observed in 51% of patients, breast fibrosis (usually mild) seen in 23% of the population, axillary hematoma or seroma formation in 15%, mild arm edema in 14% and basilic vein thrombosis in 10% of patients. The causes of these and other less frequent complications are discussed. The overall cosmetic result was excellent in 78%, satisfactory in 18% and unsatisfactory in 4% of patients. Recommendations for improving cosmetic results minimizing complications are made. In our prospective trial, the high loco-regional control and good cosmesis supports the use of excisional biopsy and radiation therapy in patients with Stages I and II breast carcinoma.
1973年5月至1980年12月期间，对76例患者的78例I期和II期乳腺癌进行了活检及根治性放疗。最长随访时间为10年，最短随访时间为2年半，中位随访时间为3年半，局部区域控制率达97%。对美容效果和治疗并发症进行了研究。分析了患者特征、肿瘤大小、切除活检技术、腋窝分期程序及放疗技术，发现这些均为影响美容效果和并发症的重要因素。最常见的并发症包括：51%的患者出现短暂性乳腺水肿，23%的患者出现乳腺纤维化（通常较轻），15%的患者出现腋窝血肿或血清肿形成，14%的患者出现轻度手臂水肿，10%的患者出现贵要静脉血栓形成。讨论了这些及其他较少见并发症的成因。总体美容效果方面，78%的患者为优，18%的患者为良，4%的患者为差。提出了改善美容效果及减少并发症的建议。在我们的前瞻性试验中，较高的局部区域控制率及良好的美容效果支持对I期和II期乳腺癌患者采用切除活检及放射治疗。
