Meme kanserinde radikal ve konservatif cerrahi yöntemlerinin karşılaştırılması

Abstract

Meme kanseri kadınlarda kanser nedeniyle ölümlerin en yaygın sebebidir. Günümüzde meme kanseri tedavisinde radikal cerrahi tedavi yada konservatif cerrahi tedavi radyoterapi ile birlikte uygulanmaktadır. Erken evre meme kanserinde konservatif cerrahi tedavi ve radyoterapi radikal cerrahi girişimler kadar etkilidir. GATA Genel Cerrahi Ana Bilim Dalı'nda 1990-1995 yıllan arasında meme kanseri tanısıyla öpere edilen ve evre I-II tümörlü 140 hastadan 106 hastaya radikal cerrahi tedavi, 34 hastaya ise konservatif cerrahi tedavi uygulanmıştır. Bütün hastalara postoperatif radyoterapi uygulanmıştır. Erken evre meme kanserli 140 hasta yaş, tümörün lokalizasyonu, tümörün büyüklüğü, tümörün histolojik tipi, tümörün klinik evresi, aksiller lenf nodu tutulumu, lokal nüks, uzak metastaz ve sağkalım oranlan açısından değerlendirilmiştir. Radikal cerrahi tedavi uygulanan 106 hastanın ortalama izlenme süresi 41,98 aydır. Ortalama hastalıksız yaşam süresi 40.87 aydır. Radikal cenahi tedavi uygulanan hastalann % 6.6'sında (7 olgu) uzak metastaz saptanmıştır. 5 hasta uzak metastaz nedeniyle ölmüştür. Sağkalım oranı % 95.3 'tür. Konservatif cerrahi tedavi uygulanan 34 hastanın ortalama izlenme süresi 31.97 aydır. Ortalama hastalıksız yaşam süresi 30.03 aydır. Konservatif cerrahi tedavi yapılan hastaların % 8.8'inde (3 olgu) uzak metastaz rastlanmıştır. 2 hasta uzak metastaz nedeniyle ölmüştür. Sağkalım oranı % 94.1'dir. Sonuç olarak: Etkin radyoterapi ile birlikte uygulanan konservatif cerrahi tedavi radikal cercahi tedaviye eşit survi sağlamaktadır. 42

SUMMARY The Comparison of Radical and Conservative Surgical Procedures in Breast Cancer Therapy Breast cancer is the most common cause of death from cancer in women. Nowadays, breast cancer has been treated with either radical surgical procedures or conservative surgery, usually with addition of radiation therapy. Breast conserving surgery followed radiation therapy in early stage breast cancer is at least as effective as more than radical surgical procedures. Between 1990-1995 years, in General Surgery Department of Gülhane Military Medical Academy, 106 patients were treated with radical surgical procedures and 34 patients were treated with conservative surgery, totally 140 patients who had stage I-II tumors were operated. All patients have been treated by radiation therapy postoperatively. 140 patients with early breast cancer have been evaluated considering the age, tumor localisation, tumor size, histological tumor type, clinical stage of tumor, axillary lymph node status, local recurrence, distant metastasis and survival rate. Median follow-up period of 106 patients who have been treated with radical procedures was 41.98 months median disease free interval was 40.87 months % 6.6 of patients (7 cases) who have been treated with radical surgical procedures were founded distant metastasis at 5 years. 5 patients were died for distant metastasis. Survival rate of 106 patients was % 95.3. Median follow-up period of 34 patients who have been treated with conservative surgery was 31.97 months. Median disease free interval was 30.03 months. % 8.8 of patients (3 cases) who have been treated with conservative surgery were founded distant metastasis at 5 years. 2 patients were died for distant metastasis. Survival rate of 34 patients was % 94.1. As a result, Breast conserving surgery with effective breast irradiation provides the same overall survival with radical surgical procedures. 43