Bluming A Z
Am J Med. 1982 May;72(5):820-8. doi: 10.1016/0002-9343(82)90549-6.
During the 54-year period between 1927 and 1981, at least 4,290 patients with breast cancer treated with lumpectomy and/or radiotherapy as the primary therapeutic modality have been described. In all but two of the 24 reported studies, survival rates, even to 30 years, were similar to those of patients treated with variations of radical mastectomy, and the cosmetic result following treatment that preserved the affected breast was judged good to excellent by 81 to 85 percent of the patients so treated. The two exceptions were both in series of patients treated with doses of radiation known to be inadequate by current standards. We all have the responsibility of offering our patients the most effective treatment available with the fewest possible short-term and long-term side effects. This goal requires a constant, careful reevaluation of our treatments and results, as well as an open mind. According to available data, the combination of lumpectomy, axillary node dissection, external beam radiotherapy and iridium implant constitutes an acceptable alternative to mastectomy as treatment for primary cancer of the breast.
在1927年至1981年的54年期间，至少有4290例乳腺癌患者接受了以肿块切除术和/或放射治疗作为主要治疗方式的治疗。在24项已报道的研究中，除两项研究外，即使到30年，生存率与接受不同改良根治性乳房切除术的患者相似，并且接受保留患侧乳房治疗后的美容效果被81%至85%接受该治疗的患者评为良好至优秀。这两个例外均出现在按当前标准已知放射剂量不足的患者系列中。我们都有责任为患者提供现有最有效的治疗方法，并尽可能减少短期和长期副作用。这一目标需要我们持续、仔细地重新评估治疗方法和结果，以及保持开放的心态。根据现有数据，肿块切除术、腋窝淋巴结清扫术、外照射放疗和铱植入相结合，构成了一种可接受的替代乳房切除术的乳腺癌原发性治疗方法。
