乳腺癌保乳术与根治术的比较

The Comparison Therapy of Breast Conservation Therapy and Breast Mastectomy

为了比较分析保乳术和根治术的治疗成本和对乳腺癌患者预后的影响,从2002年1月~2005年6月湘雅医院乳腺科的乳腺癌资料库中,随机抽取64例I^II期乳腺癌分为保乳治疗组(A组,32例)和根治术组(B组,32例),并随访。结果显示,A、B两组全部药品费用分别平均为32474.11±16126.00元、35107.30±19352.71元,总费用平均为53959.64±22033.28元、53382.10±24042.87元。两组药品费和总费用均无统计学差异(P=0.556、0.921)。中位随访时间30个月,两组病例均无局部复发。A、B组远处转移率分别为6.25%、9.38%,两组无明显差异(P=0.641);Kaplan-Meier生存分析表明A、B组生存率分别为96.88%、93.75%,两组无显著性差异(P=0.4566)。保乳术患者对残乳的满意率为90.61%,认为保留了乳房后其对家庭和社会生活仍充满自信的分别占75%和87.5%;相反,根治术者仅占28.13%和40.63%;A、B两组有显著性差异(P=0.000、0.000)。由此得出结论,保乳术和根治/改良根治术两种治疗方法对I^II期乳腺癌患者的预后无差异,成本亦无明显区别,而保乳术明显提高了患者的家庭、社会生活质量。

To compare the therapeutic cost and effect of breast conservation therapy with radical mastectorny （ including radical and modified radical mastectomy） on patients with breast cancer. 64 randomized cases of stage Ⅰ -Ⅱ breast cancer, pathologically and surgically proven in Department of Breast Surgery, XiangYa Hospital , from 2000 January to 2005 June, were included in this study . The patients were randomly divided into breast conservation therapy group （ group A, n = 32 ） and radical mastectomy group （group B, n= 32）. For analyzing the prognostic effect of therapeutic cost on patients. The mean drug cost of group A and B were ￥ 32 474.11 ± 16 126.00 and 35 107.30 ± 19 352.71respectively, and the mean total cost were ￥ 53 959.64 ± 22 033.28 and 53 382.10±24 042.87,and there was no significant difference （P= 0. 556,0. 921 ）. The median followup was 30 months, there was no regional relapse case in two groups. The distant metastasis of group A and B were 6.25% and 9.38%, and there was no significant difference （P= 0. 641 ） ; The overall survival rate were 96.88% and 93.75% and there was no significant difference （ p= 0. 4566 ） according to the Kaplan- Meier survival analysis. The ipsilateral breast satisfaction rate of group A was 90.61%, the self- confidence rate in family and society of group A were 75% and 87.5%, and group B 28.13% and 40.63% , and there were significant difference （ p = 0. 000, 0. 000 ）. There was no difference between breast conservation therapy and radical mastectomy in patients with breast cancer on prognosis and cost. The familial and social life quality of patients with conservation therapy was greatly improved because of the conserved invalid.