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Objective To evaluate prospectively the side effects and tolerance of docetaxel with concurrent late-course hyperfractionated radiotherapy after breast-conserving surgery for stage T1-T2 breast cancer, and to assess the value of this treatment in shortening the treatment time and reducing the economic burden among patients. Methods A total of 20 patients with T1-T2 breast cancer were recruited after they underwent breast-conserving surgery. The acute radiation response classification, treatment completion rate, disease-free survival, hospital stays, and treatment costs were observed. Radiotherapy for all patients was started before the last single-agent docetaxel chemotherapy. Results The completion rate of treatment and the good rate of cosmetic effect reached 100%. The main adverse reactions were hematological toxicity (leukopenia) and skin reactions, which were tolerated. The median follow-up time was 30.1 months, and the follow-up rate was 100%. The average total treatment time of this hyperfractionated radiotherapy with concurrent docetaxel was four weeks, and the total hospitalization cost savings was approximately 10, 000 yuan. The 21-month disease-free survival rate was 100%. Conclusion Stage T1-T2 breast cancer can tolerate hyperfractionated radiotherapy with concurrent chemotherapy after a breast-conserving operation. The procedure results in good local control and satisfactory cosmetic effects, with high health and economic value.
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Objective To investigate the clinical effects and complications of modified radical mastectomy and breast conserving operation for breast cancer.Methods 110 cases of breast cancer were randomly divided into the two groups,55 patients in each group,the control group took the modified radical mastectomy,while breast conser-ving operation were carried out in observation group,the clinical efficacy and incidence of complications of two groups were observed and compared.Results The operation time,intraoperative blood loss,length of incision and hospitali-zation time of the observation group were (98.47 ±8.65)min,(82.59 ±4.86)mL,(4.80 ±0.87)cm and (8.66 ± 1.77)d,significantly less than (156.52 ±10.23) min,(125.23 ±6.85) mL,(12.25 ±2.03) cm and (15.23 ± 1.85)d in the control group (t=8.12,7.58,9.88,8.72,all P0.05);The incidence of complications of the observation group was 3.63%,significantly lower than 18.18% of the control group (χ2 =8.25,P<0.05).Conclusion Breast conserving operation has a significant efficacy for breast cancer,with less trauma,quicker recovery,fewer complications,which is worthy of extensive promotion and application in clinical practice.
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Objective: To explore the relationship between margin width in extended lumpectomy for breast cancer with survival rate, local recurrence rate, and cosmetic result. Methods: The clinical data of 42 breast cancer patients who had a 2cm incision margin width (group A) and 37 who had a 3cm incision margin width (group B) were retrospectively analyzed. The 5-year, 10-year survival rates, recurrence rates, and the cosmetic results were compared between the 2 groups. Results: The 5-year and 10-year survival rates in patients of group A were 90.1% and 85.3%, respectively; in patients of group B were 92.3% and 83.6% , respectively(P>0.05). The 5-year and 10-year local recurrence rates in patients of group A were 5.9%, and 11.%, respectively; in patients of group B were 3.4% and 12.9%, respectively(P>0.05). The cosmetic result was significantly better in group A than that in group B(P<0.05). Conclusion: An incision margin width of 2 cm is enough for extended lumpectomy. It is not necessary to further expand the margin width; otherwise, it may influence the cosmetic results after operation.
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Objective To investigate the efficacy,side effects and cosmetic effects of breast-conserving operation combined with radiotherapy for patients with breast cancer. Methods Forty-three patients with early stage of breast cancer(n=30 for stage I and n=13 for stage II) were performed extended resection plus axillary lymph node dissection or quadrant resection plus axillary lymph node dissection.After operation,tangential field irradiation was conducted with 50 Gy of X ray,tumor bed was irradiated with additional 10 Gy of electron beam,and supraclavicular field irradiation was also administered with 30 Gy of X ray and 22 Gy of electron beam. Results There was no recurrence during the follow up for 14 to 50 months.The acute side effects of radiotherapy included breast complaints(n=10,grade Ⅰ,23.26%),skin erythema and hyperpigmentation(n=19,grade Ⅰ,44.19%),moist desquamation(n=5,grade Ⅱ,11.63%) and radiation esophagitis(n=4,grade Ⅰ,9.30%),while one patient experienced radiation esophagitis one month after radiotherapy.No such complications as skin fibrosis and necrosis,angiotelectasis,breast and upper extremity edema occurred.The short-term cosmetic effects were satisfactory to 93.02% of all the patients. Conclusion For early stage of breast cancer(stage I and stage Ⅱ),breast-conserving operation combined with radiotherapy may yield satisfactory survival rate and short-term cosmetic effects,as well as low incidences of side effects.
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Sentinel Node Biopsy (SNB) is beneficial for reducing axillary functional impairment and lymphedema due to extended lymph node dissection. We used the Indigo Carmine dye instead of radioisotope, since it can simplify the complicated multistep identifying procedures and has economic benefit because it requires no radioisotope detection equipment. The operation for small breast cancer is continuously changing from a modified radical mastectomy to various type of breast conserving operations. Among these we performed a partial mastectomy with rotation flap using remnant breast tissue (RFB). This method needs small operation field, so we could reduce trauma to the patient, shorten the operation time, and use natural blood supplies and tissues without destructing other organ structures. The cosmetic effect is desirable to Korean women considering their relatively small breast size as to that of western people. In SNB, 5cc indigocarmine was injected intradermally just around main lesion. Sentinel node was able to be identified easily if a proper dose was used. Its approach was achieved in 15 to 20 minutes. Partial mastectomy (quadrantectomy) was done with cancer free margins. Rotation flap which is covering the defect included as much breast tissue as possible sparing the nipple areolar complex. Sentinel node biopsy and rotation flap brought out both satisfactory cosmetic result and cost effective outcome, so this breast conserving method is recommendable to small breast cancers.
Subject(s)
Female , Humans , Biopsy , Breast Neoplasms , Breast , Equipment and Supplies , Indigo Carmine , Lymph Node Excision , Lymphedema , Mastectomy, Modified Radical , Mastectomy, Segmental , NipplesABSTRACT
Objective To explore the effect of breast-conserving operation for the treatment of early-stage breast cancer. Methods From November 1999 to Octorber 2001, the patients with early-stage breast cancer were treated with breast-conserving surgery followed by radical irradiation according to the patients' will. The cosmetic results and quality of life were analyzed after surgery and radiation. Results In all the patients received operation treatment from 1999 to 2001, eighteen patients were treated with breast-conserving surgery with breast conservation rate of 10.2%, of which 7 cases with quadrantetomy plus axillary lymph node dissection (ALND), 8 cases with lumpectomy plus ALND and 3 cases with lumpectomy. Pathological staging was as follow: 4 cases in stage 0, 12 cases in stage Ⅰ, and 2 cases in stage Ⅱ. All cases were followed-up. The cosmetic results were good in 94%(17/18) and fair in 6%(1/18). All the patients had not local recurrence and distant metastasis. Conclusions Breast-conserving surgery followed by radiation therapy is superior to mastectomy in terms of improving breast cosmesis and quality of life. Postoperative radiation therapy does not affect the cosmetic result.
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Objective To study the method and significance of preserving anterior thoracic nerve(ATN) and intercostobrachial nerve(ICBN) during breast-conserving operation for breast cancer.Methods A total of 382 cases with breast-conserving operation for breast cancer in recent 5 years were reviewed.In 312 cases the opeeration was performed by preserving ATN and ICBN,and in 70 cases the ATN and ICBN were not preserved.The patients were followed-up postoperatively.Results Among the patients whose operation was performed by preserving ATN and ICBN,skin sensation of armpit and upper arm was normal in 80.4%(251/312) and abnormal in 19.6%(61/312) of patients,but in most of them,it recovered in 2-3 months.Among the patients with out preservation of ATN and ICBN,skin sensation was normal in only 16 cases(22.9%),and had varying degrees of abnormal sensation in 54 cases(77.1%).Conclusions Preservation of ATN and ICBN during breast-conserving surgery for breast cancer is feasible,can decrease the incidence of hypoesthesia of axilla and upper arm and atrophy of pectoralis muscles,and the quality of life of patients after operation is improved.