Radiation therapy with or without primary limited surgery for operable breast cancer: A 20‐year experience at the marseilles cancer institute
Radiation therapy with or without primary limited surgery for operable breast cancer: A 20‐year experience at the marseilles cancer institute
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可手术乳腺癌的放射治疗（联合或不联合初次有限手术）：马赛癌症研究所 20 年的经验
作者：
R. Amalric;F. Santamaria;F. Robert;J. Seigle;C. Altschuler;J. Kurtz;J. Spitalier;H. Brandone;Y. Ayme;Pollet Jf;R. Burmeister;R. Abed
自 1960 年以来，连续 3000 多名可手术浸润性乳腺癌患者接受了放射治疗，有或没有进行初次有限手术，通常包括局部切除。对于小于或等于 5 cm 的肿瘤，未触及腋窝淋巴结 (T1-2Na) 的患者的十年粗生存率为 77%，有腋窝淋巴结肿大 (T1-2N1) 的患者的十年粗生存率为 63%。对于直径超过 5 厘米 (T3N0-1) 的可手术肿瘤，十年粗生存率为 34%。尽管 24% 的手术标本中没有发现残留疾病，但 35% 十年后无病生存的患者因推测局部或区域肿瘤持续存在或复发而需要进行二次手术。局部区域复发对十年生存率没有不利影响。这种保守的方法为大多数患有可手术乳腺癌的女性提供了极好的乳房保留机会，其十年生存率与根治性乳房切除术相同。
Since 1960 more than 3000 consecutive patients with operable infiltrating breast carcinoma were treated by radiation therapy with or without primary limited surgery, which usually consisted of local excision. For tumors smaller than or equal to 5 cm the ten‐year crude survival rate is 77% for patients without palpable axillary nodes (T1–2Na) and 63% for patients having axillary adenopathy (T1–2N1). For operable tumors exceeding 5 cm in diameter (T3N0–1) the ten‐year crude survival is 34%. Thirty‐five percent of the patients alive free of disease at ten years required a secondary operation for presumed local or regional tumor persistence or recurrence, although no residual disease was found in 24% of the operative specimens. Local‐regional recurrence had no adverse effect on ten‐year survival. This conservative approach offers most women with operable breast cancer an excellent chance at breast preservation with the same chance for ten‐year survival as with radical mastectomy.