摘要:
目的 初步探究经皮微波消融术对侵犯皮肤或乳头乳晕复合体(nipple-areolacomplex,NAC)的晚期乳腺癌患者的安全性和有效性。方法 以2011年1月-2024年8月中国人民解放军总医院第五医学中心皮肤或NAC受累的乳腺癌患者为研究对象,患者在水隔离技术保护周围组织的基础上接受经皮微波消融治疗,回顾性收集患者的临床资料,并分析手术治疗的技术成功率、并发症、预后以及患者对乳腺美学满意度和生活质量改善情况。结果 共19例(24处癌灶)符合纳入和排除标准的患者纳入分析,其中T4N0M0期4例、T4NIM0期2例、T4N2M0期3例、T4N3M0期1例、T4N2M1期1例、T4N3M1期8例。24处癌灶平均直径为(4.9±3.4) cm,平均消融(1.6±0.6)次,中位消融时间为36.9(26.1,61.7) min,中位消融能量为84.2(45.6,149.2) kJ,技术成功率为100%。术后7例患者(7/19,36.8%)出现病灶周围皮肤灼伤或乳头脱落,创面均自然愈合。患者中位生存期为35.0(17.0,45.5)个月,中位无复发生存期为17.0(11.0,38.5)个月。患者对治疗后乳腺美学满意度为89.5%,所有患者均认为手术显著改善了其生活质量。结论 经皮微波消融治疗皮肤或NAC受累的乳腺癌初步显示出较高的安全性和有效性,有望成为无法手术切除乳腺癌的可行治疗方案。
Abstract:
Objective To preliminarily investigate the safety and efficacy of percutaneous microwave ablation (MWA) in patients with advanced breast cancer involving the skin or nippleareola complex (NAC). Methods This study included breast cancer patients with skin or NAC involvement treated at the Fifth Medical Center of the Chinese PLA General Hospital from January 2011 to August 2024. Patients underwent percutaneous MWA with water isolation technique to protect surrounding tissues. Clinical data were retrospectively collected, and the technical success rate, complications, prognosis, patient satisfaction with breast aesthetics, and quality of life improvement were analyzed. Results A total of 19 patients (24 lesions) meeting the inclusion and exclusion criteria were analyzed. The cases included 4 with T4N0M0, 2 with T4N1M0, 3 with T4N2M0, 1 with T4N3M0, 1 with T4N2M1, and 8 with T4N3M1. The average diameter of the 24 lesions was (4.9 ± 3.4) cm, with an average of (1.6 ± 0.6) ablation sessions per lesion. The median ablation time was 36.9 (26.1, 61.7) minutes, and the median ablation energy was 84.2 (45.6, 149.2) kJ. The technical success rate was 100%. Postoperatively, 7 patients (7/19, 36.8%) experienced skin burns around the lesion or nipple shedding, all of which healed naturally. The median overall survival was 35.0 (17.0, 45.5) months, and the median recurrence-free survival was 17.0 (11.0, 38.5) months. Patient satisfaction with post-treatment breast aesthetics was 89.5%, and all patients reported significant improvement in their quality of life. Conclusion Percutaneous microwave ablation for breast cancer involving the skin or NAC was preliminary demonstrates to be safe and effective, suggesting its potential as a viable treatment option for patients with inoperable breast cancer.
作者投稿
专家审稿
编辑办公
邮件订阅
RSS
下载:
