[乳腺癌:走向极简局部治疗的进化]。

J-M Nogaret
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引用次数: 0

摘要

乳腺癌至今仍是女性中最常见的癌症,就这一点而言,它是比利时男性和女性中最常见的癌症。目前,每年发现的病例超过9000例。幸运的是,筛查的发展使我们能够更早地发现病变和分期,从而使局部治疗有了很大的发展。自20世纪70年代以来,乳房根治性切除术(包括切除乳腺、腋腺(淋巴结),有时还切除胸肌)已逐渐被温室疗法所取代。这包括在安全切除范围内广泛切除肿瘤,然后完全切除腋腺(淋巴结),然后进行一个疗程的外部放疗测试,每天治疗6周,每周5天。在九十年代,在有某些确切适应症的情况下,完全切除腋腺已被切除称为“前哨淋巴结”的第一腺链(淋巴结链)所取代。这项技术避免了所有与淋巴结完全切除相关的发病率。最后,最近,经典的外部放射治疗已被部分放射治疗所取代,在手术过程中仅在几分钟内进行。因此,我们可以为早期病变患者提供一到两个小时的局部治疗,住院两晚。这项新技术显然能更好地局部控制这种疾病,而且很有可能提高他们康复的机会。
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[Breast cancer: towards an evolution of minimalist locoregional therapy].

Breast cancer remains by far the most frequent cancer in women, for that matter it is the most frequent cancer in Belgium affecting both men and women. At the moment, more than 9000 cases are detected annually. The development of screening allows us, fortunately, to detect lesions and stages earlier, in that way locoregional treatmenthas considerably evolved. Since the seventies, radical mastectomy, which consists of the removal ofthe mammary gland, the axillary glands (lymph nodes) and sometimes the pectoral muscle, has been progressively replaced by conservatory treatment. This consists of a wide excision of the tumour with a safety resection margin, followed by a complete removal of the axillary glands (lymph nodes) then followed by a course of external radiotherapy testing treated six weeks daily on a five days week basis. During the nineties, in cases with certain precise indications, the complete axillary gland removal has been replaced by the removal of the first gland chain (lymph node chain) called "sentinel nodes". This technique avoids all morbidity associated to the complete lymph node removal. Finally, very recently, the classic external radiotherapy has been replaced by partial radiotherapy delivered exclusively in a few minutes during the surgical operation. Therefore, we can offer patients with early stage lesions a locoregional treatment carried out in one to two hours with an in-stay hospitalisation of two nights. This new technique manifestly offers a better locoregional control of the illness and very likely enhances (improves) their chances of recovery.

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