手术治疗单一局部复发或远处转移病灶乳腺癌的临床观察

探索手术治疗单一局部复发或唯一远处转移病灶乳腺癌的临床价值。收集2006年6月至2013年6月湖南省人民医院乳甲外科收治的64例局部复发或术后远处转移乳腺癌患者，其中28例为单发病灶病例。根据是否采取了包含手术的综合治疗，将其分为手术组与非手术组。回顾性分析两组的临床资料和随访数据，分析手术治疗局部复发或远处转移乳腺癌有无临床意义。结果28例都采取了含化疗的综合治疗，8例局部单发病灶与9例远处单一脏器转移病例进行了手术治疗。手术组的局部缓解率与控制率明显优于非手术组，均为100％。两组无进展生存时间（PFS）和总生存时间（（）S）比较，手术组明显长于非手术组；但在单一远处脏器转移手术组中0S没有优势。2年生存率方面手术组与非手术组比较有统计学意义。对于术后单一局部复发病灶或唯一远处脏器转移的乳腺癌患者，采取含手术的综合治疗方案能带来明显的PFS优势，若有手术机会和条件成熟，手术仍是不应放弃的有效治疗方法。

Clinical Observation on Surgical Treatment of Single Local Recurrence or Distant Metastasis Lesions of Breast Cancer

To explore the clinical value of surgical treatment to a single Local recurrence or distant metastasis of breast cancer. We collected 64 cases of breast cancer patients that have local recurrence or distant metastases from June 2006 to June 2013 in Hunan Provincial People＇s Hospital,including 28 cases of single lesion cases. Depending on whether to take a comprehensive treatment includes surgery or not, we divided the cases into surgical group or non-surgical group. A retrospective analysis of two sets of clinical data and follow-up data was collected to analysis the clinical value of the surgery to the patients with local recurrence and distant metastasis. 28 cases have taken a comprehensive treatment with chemotherapy, eight cases of partial single lesion and nine cases o{ a single distant metastasis have taken a surgery. Partial remission rate and control rate of surgical group were significantly better than that of the non-surgical group that both are 100%. Two PFS and OS were compared. Surgery group was significantly longer than non-surgical group; however, to OS, there is no advantage in the surgical group that with a single distant metastasis. Compared the surgical group with non-surgical group, 2-year survival rate was statistically significant. For a breast cancer patient after surgery with single local recurrence or distant unique metastasis, comprehensive treatment program including surgery can bring significant advantage of PFS. Surgery is still an effective treatment methods in certain conditions and doctors should never give up if there is opportunity for surgery and the conditions enough.