Objective To observe the therapeutic effectiveness of comprehensive treatment for breast can-cer,and to provide reference for clinical therapy.Methods A total of 1 240 breast cancer patients were followed up from January 2010 to December 2012 in Shanxi Provincial Cancer Hospital,including 883 cases of ductal type,260 cases of human epidermal growth factor receptor-2(HER-2)type,and 97 cases of triple negative breast cancer(TNBC).There were a total of 275 cases of breast conserving surgery(BCS),preoperative neoadjuvant chemothera-py,or postoperative radiotherapy and chemotherapy;and 965 cases of modified radical mastectomy(IRM),preop-erative neoadjuvant chemotherapy,or postoperative radiotherapy and chemotherapy.After BCS and IRM,routine postoperative whole breast,whole chest wall intensity modulated radiotherapy(IMRT),and clavicular lymph drainage area radiotherapy were performed on both sides,with a DT of approximately 50 Gy.For patients with positive axillary lymph node metastasis,supplementary irradiation was administered to the axillary region with a dose of 60-70 Gy.For those who were ER positive,adjuvant endocrine therapy was administered.For patients who were HER-2 positive,trastuzumab monoclonal antibody targeted therapy was added.Results The five-year survi-val rates of BCS and IRM were 81.8％and 78.2％,respectively(P＞0.05).Among them,those without axillary lymph node metastasis had a survival rate of 91.8％;those with 1-3 axillary lymph node metastases had a survival rate of 74.0％;and those with more than 4 axillary lymph node metastases had a survival rate of 63.0％.There was a statistically significant difference in the five-year survival rate between patients with more than four lymph node metastases and those without metastases(P＜0.01).The five-year survival rates for ductal sutype,HER-2 sutype and TNBC sutype were 98.0％,37.7％and 17.5％,respectively.Conclusion The ductal sutype is sensitive to en-docrine therapy and has the best prognosis.The HER-2 subtype responds well to HER-2 targeted drugs,with a moderate prognosis.TNBC subtype is characterized by strong invasiveness,limited efficacy of endocrine and tar-geted therapy,and the poorest prognosis.Immunohistochemical subtype and the extent of axillary lymph node metastasis are important factors affecting prognosis.
关键词
乳腺肿瘤/人表皮生长因子受体2/乳房切除术,改良根治性/放化疗,辅助
Key words
Breast neoplasms/HER-2 type/Mastectomy,modified radical/Chemoradiotherapy,adjuvant
维普
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