BIOPSY AND DEFINITIVE RADIATION-THERAPY IN STAGE-I AND STAGE-II ADENOCARCINOMA OF THE FEMALE BREAST - ANALYSIS OF COSMESIS AND THE ROLE OF ELECTRON-BEAM SUPPLEMENTATION
BIOPSY AND DEFINITIVE RADIATION-THERAPY IN STAGE-I AND STAGE-II ADENOCARCINOMA OF THE FEMALE BREAST - ANALYSIS OF COSMESIS AND THE ROLE OF ELECTRON-BEAM SUPPLEMENTATION
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DOI：
10.1016/0360-3016(83)90006-8
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发表时间：
1983-01-01
影响因子：
7
通讯作者：
FISH, VJ
中科院分区：
文献类型：
--
作者：
RAY, GR;FISH, VJ
对130例经活检和放射治疗的I期和II期乳腺癌患者的美容和功能结果进行了评估。107例（82%）患者的美容结果为优，17例（13%）为可接受，6例（5%）为不可接受。完全腋窝解剖（CAD）比有限腋窝解剖（LAD）作为放射治疗前腋窝分期的一种手段更病态。前者比后者更常与乳房水肿、血肿形成和随后的手臂水肿相关。一项多变量分析显示，与获得良好的美容结果相关的4个最主要的变量是：保守活检程序的表现；小胸围（罩杯A和B）；电子能量等于或小于12mev的使用；原发肿瘤的存在。直径4厘米时调整乳房大小。107例（82%）患者通过电子对原发肿瘤区域进行体外束补充，23例（18%）患者通过间质植入。107例患者中有97例（91%）获得了良好的美容效果。如果遵循特定的适应症和指南，电子的使用似乎可以产生与间质植入相同的局部控制和美容，并且在某些临床环境中优于植入。
The cosmetic and functional outcome in 130 patients with Stages I and II carcinoma of the breast treated by biopsy and radiation therapy were evaluated. The cosmetic outcome was excellent in 107 patients (82%), acceptable in 17 patients (13%), and unacceptable in 6 patients (5%). Complete axillary dissection (CAD) was more morbid than limited axillary dissection (LAD) as a means of preradiotherapy staging of the axilla. The former was more often associated with breast edema, hematoma formation, and subsequent development of arm edema than the latter. A multivariate analysis revealed that the 4 most dominant variables associated with the attainment of an excellent cosmetic outcome were: the performance of a conservative biopsy procedure; small breast size (cup size A and B); the use of electron energies equal to or less than 12 MeV; and the presence of primary tumors .ltoreq. 4 cm in diameter when adjusted for breast size. Postexternal beam supplementation to the area of the primary tumor was accomplished with electrons in 107 patients (82%) and with interstitial implantation in 23 patients (18%). Excellent cosmetic results were achieved in 97 of the 107 patients (91%) treated with electrons. The use of electrons appears to produce local control and cosmesis equal to that of interstitial implantation if specific indications and guidelines are followed, and is superior to implantation in certain clinical settings.