유방암의 치료에 있어서 유방보존술과 변형근치유방절제술의 비교

Abstract

Modern prospective studies have demonstrated that breast conservation procedure (BCP) and modified radical mastectomy (MRM) produce comparable actuarial survival rates. This study was designed to evaluate the merit of BCP in the treatment of breast cancer. 134 patients underwent BCP during the period of Aug. 1987 to Aug. 2000 (BCP group), and they were compared with patients who underwent MRM during the same period (MRM group). Tumor size, lymph node status and age were similar between the two groups. The clinicopathologic features, locoregional recurrence, distant metastasis, actuarial overall survival rate and disease-free survival rate were analyzed. The mean age of the BCP group was 44.6 yrs, and that of the MRM group was 44.8 yrs. The mean size of tumor was 1.89 cm in the BCP group and 1.92 cm in the MRM group. Among the 134 patients in the BCP group, no lymph node metastasis was observed in 92 (68.7%), 1-3 lymph node(s) in 26 (19.4%), and more than 4 lymph nodes in 16 (11.9%). In the MRM group, the numbers were the same. In the BCP group, the actuarial 5-yr overall survival rate was 88.20% and the 5-yr disease-free survival rate was 84.2%. For the MRM group, the actuarial 5-yr overall survival rate was 85.7% and 5-yr disease-free survival rate was 80.4%, showing no significant difference between two groups. Thirteen in the 134 BCP group and five in the 134 MRM group had locoregional recurrences and five in the 134 BCP group and 17 in the 134 MRM group had distant metastases. The above results suggest that BCP can be a standard surgical treatment modality for most patients with early stage breast cancer.