Calcagno A, Marino G, Rimassa P L
Minerva Chir. 1981 Mar 31;36(6):367-74.
The authors review all the breast diseases and tumours observed from 1972 through 1979 at the Division of Surgery, Hospital of Rapallo. On the basis of personal experience they discuss the possibility that, in the treatment of early breast cancer, a relatively conservative surgery (i.e. quadrantectomy), followed by postoperative radiotherapy and adjuvant chemotherapy in the N+ cases, give no worse results than standard radical mastectomy, in preventing local relapses and distant metastases, and therefore in conditioning both free-of-disease interval and survival of the patients, as many Authors in these last years have well shown either for quadrantectomy or other conservative procedures. This retrospective study particularly evaluates the results of 12 quadrantectomies performed in Stage I and II, compared to 8 Halsted radical mastectomies in the same Stages: all patients in the two groups survive free of disease (follow-up for the quadrantectomies from 6 to 41 months). Furthermore 4 cases of Stage III breast cancer are presented, 2 treated with Halsted procedure: in the first case the death occurred at 19 months, after the development of distant metastases, while in the second local relapses have been observed at 11 and 30 months; 2 patients were treated with quadrantectomy, as they didn't accepted a radical procedure: both survive free of disease at 17 and 23 months respectively.
作者回顾了1972年至1979年期间在拉帕洛医院外科观察到的所有乳腺疾病和肿瘤。基于个人经验,他们讨论了在早期乳腺癌治疗中,相对保守的手术(即象限切除术),随后对N+病例进行术后放疗和辅助化疗,在预防局部复发和远处转移方面,其效果不比标准根治性乳房切除术差,因此在决定患者的无病生存期和生存率方面也是如此,正如近年来许多作者对象限切除术或其他保守手术所充分证明的那样。这项回顾性研究特别评估了12例I期和II期象限切除术的结果,并与同期8例哈尔斯特德根治性乳房切除术的结果进行了比较:两组所有患者均无病生存(象限切除术患者的随访时间为6至41个月)。此外,还介绍了4例III期乳腺癌病例,其中2例采用哈尔斯特德手术治疗:第一例在出现远处转移后19个月死亡,而第二例在11个月和30个月时出现局部复发;2例患者因不接受根治性手术而接受了象限切除术治疗:二者分别在17个月和23个月时无病生存。