摘要目的:分析可手术乳腺癌的手术方式，并对随访结果进行分析。方法:回顾性分析2008年7月—2018年4月淄博市第一医院收治的636例可手术乳腺癌患者的临床及病理资料，分析4种手术方式所占的比例，并通过随访，分析不同手术方式的治疗效果。结果:全部患者均为女性，年龄为26～80岁。636例乳腺癌患者中，分期：Tis 18例，Ⅰ期143例，Ⅱ期354例，Ⅲ期114例，Ⅳ7例。手术方式分为4种：(1)保乳手术＋前哨淋巴结活检124例(19.50%)；(2)保乳手术＋腋窝淋巴结清扫39例(6.13%)；(3)乳房切除术＋前哨淋巴结活检163例(25.63%)；(4)改良根治手术310例(48.74%)。实施前哨淋巴结活检427例(67.14%)，成功404例(94.61%)。全部患者中，腋窝淋巴结阴性384例(60.38%)。随访1～9年，保乳手术后局部复发11例，占保乳手术的6.75%；乳房切除胸壁局部复发43例，占乳房切除手术的9.09%；淋巴结清扫术后，腋窝淋巴结及锁骨上淋巴结复发转移33例，前哨淋巴结活检术后腋窝复发4例。结论:本组病例保乳手术比例较高，且保乳手术的局部复发率小于乳房切除组；单纯改良根治手术比例进一步下降；全组病例中，伴有腋窝淋巴结转移者占比较少。合理的手术方式选择是改善乳腺癌预后的重要因素。

abstractsObjective:To analyze the surgical methods of operable breast cancer and analyze the follow-up results.Methods:A retrospective analysis of the clinical and pathological data of 636 operable breast cancer patients admitted to Zibo First Hospital from July 2008 to April 2018, including the clinical stage, pathological staging. Analyze of the proportion of four surgical methods, and through follow-up, analyze the treatment effect of different surgical methods.Results:All patients are female, aged 26-80 years, the clinical stage of 636 patients: Tis 18 cases, stage Ⅰ 143 cases, stage Ⅱ 354 cases, stage Ⅲ 114 cases, stage Ⅳ 7 cases. There are four types of surgery: ① breast conserving surgery + sentinel lymph node biopsy in 124 cases (19.50%); ② breast conserving surgery + axillary lymph node dissection in 39 cases (6.13%); ③ mastectomy + sentinel lymph node biopsy in 163 cases (25.63%); ④ modified radical surgery in 310 cases (48.74%). Sentinel lymph node biopsy in 427 cases (67.14%), success in 404 patients (94.61%); all patients with lymph node negative 384 cases (60.38%). Follow-up for 1 to 9 years, 11 cases of local recurrence after breast-conserving surgery, It accounted for 6.75% of breast-conserving surgery; 43 cases of local recurrence of chest wall after mastectomy, accounting for mastectomy 9.09%; 33 cases of recurrence and metastasis of axillary lymph nodes and supraclavicular lymph nodes, 4 cases of axillary recurrence after sentinel lymph node biopsy.Conclusions:The proportion of breast-conserving surgery in this group of patients was high and the local recurrence rate of breast-conserving surgery was less than that of mastectomy group; the proportion of simple modified radical surgery declined further; patients with axillary lymph node metastasis were less in the whole group. The choice of reasonable operation method is an important factor to improve the prognosis of breast cancer.