| [Objective] This study aims at assess the therapeutic effect of breast conserving surgery (BCS) for breast cancer (BC) patients from the Turner Hospital of Yunnan Province, and make the concept of breast conserving therapy spreads and BCS promots further in China.[Methods] One hundred eighty-seven female patients with BC who diagnosed in the Turner Hospital of Yunnan Province between January 2003 and December 2009 were enrolled into a randomized trial of BCS. Studied their general situation, pathology, preoperative and postoperative treatment retrospectively, and followed up for 5 years and 10 years by outpatient, inpatient or telephone, calculated the overall survival (OS), disease-free survival (DFS), local recurrence rate, distant metastasis rate, mortality, and excellent and good rate of ipsilateral breast evaluationa at 5 and 10 years, then make a comprehensive assessment of the therapeutic effect of BCS.[Results] 1. Surgery:there were a total of 4092 patients with BC received surgical treatment in the Tumor Hospital of Yunnan Province during the period January 2003 through December 2009, including 4081 female and 11 male,374 women with BC received BCS, accounting for 9.14%.2. Pathology:In the study, all the patients were diagnosed by preoperative biopsy or intraoperative frozen pathological diagnosis. The complete study cohort included 145 women with invasive ductal carcinoma,7 of whom had invasive tubular carcinoma, 6 with medullary carcinoma, invasive lobular carcinoma, mucinous carcinoma and sarcoma was five cases respectively, two patients with carcinoma in situ, one was occult breast cancer, with an additional 7 patients for other.46 of them had axillary lymph node matastesis and 135 were not involved, six patients’axillary status could not be accessed in addition. IHC:hormone receptor<ER and (or) PR (+)> positive for 119 patients,46 negative, and the remaining 22 unknown; HER-2/CerBb-2 gene expression on 138 patients were(+～+++), negative for 24 cases and 25 without detection; Ki-67 expression negative for 5 cases,<5% to> 95% of those 96 cases and the remaining unknown.3. Follow-up findings3.1 Follow-up:until March 2015, follow-up time was 74 to 146 months for the whole cohort, with a median follow-up of 119 month.187 patients had a 5-year follow-up,13 of them were missed and the actual number was 174, the follow-up rate was 93.05%.36 cases were eligible for 10 years follow-up, three cases missed, follow-up rate was 91.67%.3.2 Evaluation of ipsilateral breast:according to the "fifth" Task Force evaluation criteria of cosmetology, the evaluation of postoperative breast shape divided into 3 grades:excellent, good and poor. In this study, for the 5-year follow-up patients, 15 of whom were poor,61 excellent, and the rest were good; for the 10-year follow-up patients, three patients were poor,10 excellent and the remaining were good.3.3 Assessment of therapeutic effect:according to follow-up results, three patients developed locoregional recurrence,11 patients developed distant metastases and seven of them death within 5 years, with a 5-year OS of 95.98%, DFS of 87.93%, local recurrence rate of 1.72%, distant metastasis rate of 6.32%, mortality of 4.02% and the excellent and good rate regarding cosmetic assessment of 91.02%. Correspondingly, for the 10-year follow up patients, one developed locoregional recurrence, four of whom accused distant metastases and 3 patients death from breast cancer, with a 10-year OS of 90.91%, DFS of 75.76%, local recurrence rate of 3.03%, distant metastasis rate of 12.12%, mortality of 9.09% and the excellent and good rate regarding cosmetic assessment of 87.88%.[Conclusion] 1. We can benefit significantly from BCS with radiotherapy, such as good survival, local control and cosmetic results, improve the quality of life in addition. So it can be treated as the preferred option in the management of the early stage BC and lacal advanced BC that sensitive to chemotherapy;2. The long-term survival of more than 5 years after BCS still needs validate by increasing the sample size and more in-depth study;... |
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