乳腺癌的手术演乳腺癌的手术演变及方式选择变及方式选择目录目录乳腺癌手术治疗演变历程乳腺癌手术治疗演变历程1乳腺癌根治术乳腺癌根治术3.1乳腺癌手术治疗方式及选择乳腺癌手术治疗方式及选择3小结小结4乳腺癌手术治疗适应证和禁忌证乳腺癌手术治疗适应证和禁忌证2扩大乳癌根治术扩大乳癌根治术3.2改良乳癌根治术改良乳癌根治术3.3保留乳房的乳腺癌切除术保留乳房的乳腺癌切除术3.5单纯乳房切除术单纯乳房切除术3.4Primary tumor (T) TX，T0，Tis，T1，T2，T3，T4TX: PrimarytumorcannotbeassessedT0: NoevidenceofprimarytumorTis: Intraductalcarcinoma,lobularcarcinomain situ,orPagetdiseaseofthenipplewithnoassociatedinvasionofnormalbreasttissueTis (DCIS): Ductalcarcinomain situTis (LCIS): Lobularcarcinomain situTis (Paget): Pagetdiseaseofthenipplewithnotumor.T1:Tumornotlargerthan2.0cmingreatestdimensionT1mic:0.1cmT1a:0.1cm0.5cmT1b:0.5cm1cmT1c:1.0cm2.0cmT4: Tumorofanysizewithdirectextensiontochestwallorskin.T4a:Extensiontochestwall,notincludingpectoralismuscleT4b:Edema(includingpeaudorange)orulcerationoftheskinofthebreast,orsatelliteskinnodulesT4c:BothT4aandT4bT4d:InflammatorycarcinomaRegional lymph nodes (N) NX，N0，N1，N2，N3NX: Regionallymphnodescannotbeassessed.N0: NoregionallymphnodemetastasisN1: Metastasistomovableipsilateralaxillarylymphnode(s)N2: Metastasistoipsilateralaxillarylymphnode(s)fixedormatted,orinclinicallyapparent*ipsilateralinternalmammarynodesintheabsenceofclinicallyevidentlymphnodemetastasisN2a:Metastasisinipsilateralaxillarylymphnodesfixedtooneanother(matted)ortootherstructuresN2b:Metastasisonlyinclinicallyapparent*ipsilateralinternalmammarynodesandintheabsenceofclinicallyevidentaxillarylymphnodemetastasisN3:N3a:Metastasisinipsilateralinfraclavicularlymphnode(s)N3b:Metastasisinipsilateralinternalmammarylymphnode(s)andaxillarylymphnode(s)N3c:Metastasisinipsilateralsupraclavicularlymphnode(s)Distant metastasis (M) MX:PresenceofdistantmetastasiscannotbeassessedM0:NodistantmetastasisM1:DistantmetastasisAJCC Stage Groupings Stage0Tis,N0,M0StageIT1,N0,M0StageIIAT0,N1,M0T1,N1,M0T2,N0,M0StageIIBT2,N1,M0T3,N0,M0StageIIIAT0,N2,M0T1,N2,M0T2,N2,M0T3,N1,M0T3,N2,M0StageIIIBT4,N0,M0T4,N1,M0T4,N2,M0StageIIICAnyT,N3,M0StageIVAnyT,AnyN,M14、总结、总结推荐网站及文献：1、http:/www.nice.org.uk/（NHS）2、http:/www.nccn.org/professionals/physician_gls/f_guidelines.asp?button=1+Agree（NationalComprehensiveCancerNetwork）3、http:/breast-cancer-research.com/home