乳腺癌保乳术与改良根治术的临床对比研究

A COMPARATIVE STUDY ON BREAST CONSERVING SURGERY AND MODIFIED RADICAL MASTECTOMY FOR BREAST CANCER

目的通过早期乳腺癌保乳手术与改良根治术疗效的比较,探讨早期乳腺癌保乳手术的可行性。方法回顾性分析乳腺癌患者547例,符合保乳手术标准的206例,其中行保乳手术(A组)43例。选出改良根治组(B组)患者86例。A组43例与B组86例进行临床对比研究。结果 A组与B组手术时间、术中出血量、术后引流总量、术后引流时间比较,差异有统计学意义(P<0.05);2组清扫淋巴结个数的比较,差异无统计学意义(P>0.05)。A组与B组并发症的比较,2组患侧上肢水肿发生率比较差异无统计学意义(P>0.05);切缘皮瓣缺血情况的比较差异有统计学意义(P<0.05)。A组与B组总生存率、总局部复发率、总远处转移率差异无统计学意义(P>0.05)。结论保乳手术对于早期乳腺癌患者是一种较好术式。

Objective To discuss the feasibility of breast-conserving treatment by comparing the outcome of breast-conserving surgery and modified radical mastectomy for breast cancer. Methods Retrospective analysis of 547 breast cancer patients treated with operation was carried out. Among 206 cases qualified the indication of breast conserving surgery, only 43 cases were treated with breast conserving surgery. Eighty-six cases were selected from modified radical mastectomy patients to match 43 patients treated with breast conserving surgery. Results There was significant difference between two groups in operation time, blood loss, total drainage volume,days of drainage （ P 〈0.05）. There was no significant difference in number of lymph node dissection between two groups（ P 〉0.05）. There was no significant difference in ipsilateral upper limb edema rate （ P〉0.05）, but there was significant difference in margin flap isehemia（ P 〈0.05）. There was no significant difference in the rate Of survival, local recurrence and metastasis between two groups （ P 〉0.05）. Conclusion There are many advantages in breast conserving surgery including minimal invasion, faster recovery, less operative complications, keeping the breast,increasing the cosmetic outcome and improving the life quality,etc.