CAJ | 학술논문

目的：探讨乳腺癌肿块局部切除后行保乳手术的可行性和安全性。方法回顾性分析2009年1月～2011年12月26例在外院行乳腺肿块局部切除后要求行保乳手术的乳腺癌患者临床资料，均为单发浸润性导管癌，术前分期为T1 N0 M0。局部切除至保乳手术间隔6～24 d，平均10 d；术前肿块直径1～2 cm，平均1．6 cm；原手术切口至乳头的最短距离2～6 cm，平均4．5 cm。结果26例均顺利完成保乳手术，联合前哨淋巴结活检术15例，腋窝淋巴结清扫术11例。手术切口全部Ⅰ期愈合，住院时间3～5 d。术后均完成全乳放疗。随访2～5年，中位随访时间32个月，未发现局部复发和远处转移，乳房外观及生活质量满意。结论对已行乳腺癌肿块局部切除但具备保乳条件、且有保乳愿望的患者，如果掌握比常规保乳手术更加严格的适应证，可以施行保乳手术。
목적：탐토유선암종괴국부절제후행보유수술적가행성화안전성。방법회고성분석2009년1월～2011년12월26례재외원행유선종괴국부절제후요구행보유수술적유선암환자림상자료，균위단발침윤성도관암，술전분기위T1 N0 M0。국부절제지보유수술간격6～24 d，평균10 d；술전종괴직경1～2 cm，평균1．6 cm；원수술절구지유두적최단거리2～6 cm，평균4．5 cm。결과26례균순리완성보유수술，연합전초림파결활검술15례，액와림파결청소술11례。수술절구전부Ⅰ기유합，주원시간3～5 d。술후균완성전유방료。수방2～5년，중위수방시간32개월，미발현국부복발화원처전이，유방외관급생활질량만의。결론대이행유선암종괴국부절제단구비보유조건、차유보유원망적환자，여과장악비상규보유수술경가엄격적괄응증，가이시행보유수술。
Objective To explore the feasibility and safety of breast conserving surgery ( BCS) in patients with early breast cancer after local lumpectomy . Methods Clinical data of 26 patients who previously had received local lumpectomy from January 2009 to December 2011 were retrospectively analyzed .All the patients were diagnosed as solitary invasive ductal carcinoma with preoperative staging of T1N0M0.The interval from lumpectomy to BCS was 6-24 days (mean, 10 days) and the maximum diameter of tumors before first operation was 1-2 cm (mean, 1.6 cm).The shortest distance between nipple and operative incision was 2-6 cm (mean, 4.5 cm). Results The operations were successfully completed in all 26 patients, 15 of which received sentinel lymph node biopsy and 11 of which received axillary lymph node dissection .The hospital stay was 3-5 days with stage-Ⅰhealing of incision .All patients received whole breast radiation therapy after BCS .There was no local recurrence or distant metastasis during 2 -5 year ’ s follow-up (median, 32 months).All the patients were satisfied with the shape of breast and the quality of life . Conclusion For those patients with early breast cancer who have received local lumpectomy , meet the requirement of CBS , and have the willing of breast conserving , BCS is an ideal choice after rigid application of surgical indications .