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首页> 外文期刊>British Journal of Cancer >Long-term follow-up of elderly patients with operable breast cancer treated with surgery without axillary dissection plus adjuvant tamoxifen
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Long-term follow-up of elderly patients with operable breast cancer treated with surgery without axillary dissection plus adjuvant tamoxifen

机译：老年可手术乳腺癌患者的长期随访，无腋淋巴结清扫术和他莫昔芬辅助治疗

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摘要

Between 1982 and 1990, 321 elderly patients (range 70-92 years, median age 77) with operable breast cancer (T1 in 219, T2 in 77, T3 in one and T4b in 24 patients) and clinically uninvolved axillary nodes underwent surgery without axillary dissection and received adjuvant tamoxifen. All patients had surgery performed under local anaesthesia. Tamoxifen was given after surgery at the dose of 20 mg daily, indefinitely. With a median follow-up of 67 months (range 42-141), 17 patients developed local relapse, 14 ipsilateral axillary recurrence, five ipsilateral breast cancer, five contralateral breast cancer, 13 second primary and 23 developed distant metastases. The cumulative probability of developing a local, axillary and distant recurrence at 72 months was estimated to be 5.4%, 4.3% and 6.2%, respectively. Out of 244 patients who did not develop any relapse, 83 (25.8%) died from intercurrent disease. The 72 month relapse-free survival rate was 76%. This experience suggests that elderly patients with small tumours without clinical axillary involvement may be satisfactorily treated with conservative surgery and tamoxifen. The importance of axillary dissection is controversial owing to a high response rate to hormonal therapy and an increased death rate due to concomitant diseases.
机译：在1982年至1990年之间，对321名患有可手术的乳腺癌（T1 219，T2 77，T3 1以及T4b 24例）且临床上未受累的腋窝淋巴结转移的老年患者（范围70-92岁，中位年龄77）进行了无腋窝手术解剖并接受他莫昔芬的辅助治疗。所有患者均在局部麻醉下进行手术。手术后无限期给予他莫昔芬，每天20 mg。中位随访67个月（范围42-141），有17例患者出现局部复发，14例同侧腋窝复发，5例同侧乳腺癌，5例对侧乳腺癌，13例第二原发癌和23例发生远处转移。估计在72个月出现局部，腋窝和远处复发的累积概率分别为5.4％，4.3％和6.2％。在244例未复发的患者中，有83例（25.8％）死于并发疾病。 72个月无复发生存率为76％。这项经验表明，保守性手术和他莫昔芬可以令人满意地治疗老年小肿瘤，无临床腋窝受累的老年患者。由于对激素疗法的高反应率和伴随疾病引起的死亡率增加，腋窝夹层的重要性引起争议。

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