Weber B, Demange L, Rigaud C, Fernandez-Valoni A
Centre Alexis-Vautrin, Vandoeuvre-lès-Nancy.
Bull Cancer. 1998 Sep;85(9):755-62.
Does radical mastectomy for cancer remain needed? Breast conserving treatment may be achieved by surgery, primary chemotherapy followed by radiotherapy and surgery. This article attempts at defining (according to clinical and pathological parameters of the tumor and patient's characteristics), when conservative treatment is not allowed and radical mastectomy must be performed. Mastectomy must be performed first when there are multiple tumors or a tumor too large with respect to the breast volume or diffuse microcalcifications on mammograms. Sometimes the stage of pregnancy, a personal history of collagen vascular disease or prior radiotherapy or the willing of the patient lead to perform radical mastectomy. Secondary mastectomy is necessary in case of failure of conservative treatment or recurrence after breast conserving treatment.
癌症根治性乳房切除术是否仍有必要？保乳治疗可通过手术、先进行化疗再放疗和手术来实现。本文试图根据肿瘤的临床和病理参数以及患者特征来确定何时不允许进行保乳治疗而必须进行根治性乳房切除术。当存在多个肿瘤、肿瘤相对于乳房体积过大或乳房X光片上有弥漫性微钙化时，必须首先进行乳房切除术。有时，怀孕阶段、胶原血管疾病个人史、既往放疗史或患者的意愿会导致进行根治性乳房切除术。如果保乳治疗失败或保乳治疗后复发，则有必要进行二次乳房切除术。
