保乳术与改良根治术对育龄期乳腺癌患者复发及生存情况的影响

Breast-conserving surgery versus modified radical operation for breast cancer women in child bearing age: analysis of postoperative recurrence and survival

目的:比较保乳术与改良根治术对育龄期乳腺癌患者术后复发及生存情况。方法:收集2005年1月—2010年6月收治的育龄期乳腺癌82例临床资料,其中行保乳手术48例(保乳组),乳腺癌改良根治术34例(改良根治组)。对两组患者手术情况、并发症、复发、转移及生活质量进行评估。结果:与改良根治组比较,保乳组手术时间[(74.4±8.3)min vs.(92.6±10.7)min]、术中出血量[(46.8±6.7)mL vs.(77.0±68.4)mL]、引流量[(398.8±41.3)mL vs.(601.4±62.7)mL]均明显减少、住院时间明显缩短[(13.4±3.2)d vs.(17.9±2.8)d],并发症发生率明显降低(6.3%vs.14.7%)(均P<0.05);两组1,2年复发和转移率比较,差异无统计学意义(P>0.05);保乳组的社会功能、情绪功能、角色功能和躯体功能评分均高于改良根治组(均P<0.05)。结论:对育龄期乳腺癌患者,保乳术与改良根治术在复发和转移方面无差异,但前者术后的生存质量优于后者。

Objective： To compare the postoperative recurrence and survival between breast-conserving surgery and modified radical operation in breast cancer women in child bearing age. Methods： ~he clinical data of 82 breast cancer women in child bearing age admitted from January 2005 to June 2010 were collected. Of the patients, 48 cases （breast-conserving group） underwent breast-conserving therapy and 34 cases （modified radical operation group） were subjected to modified radical operation. ~he intraoperative conditions, postoperative complications, recurrence, metastasis, and quality of life of the two groups of patients were analyzed. Results： In breast-conserving group compared with modified radical operation group, the operative time [（74.4＋8.3） min vs. （92.6＋_10.7） mini, intraoperative blood loss [（46.8＋6.7） mL vs. （77.0＋-68.4） mL] and drainage volume [（398.8＋-41.3） mL vs. （601.4＋62.7） mL] were significantly reduced, the length of hospital stay [ （13.4＋3.2） d vs. （17.9＋-2.8） d] was significantly shortened, and the incidence of postoperative complications （6.3% vs. 14.7%） was significantly decreased （all P〈0.05）. The 1- and 2-year recurrence or metastasis rate showed no statistical difference between the two groups （P〉0.05）. The scores for social, emotional, role and physical function in breast-conserving group were all significantly higher than those in modified radical operation group （all P〈0.05）. Conclusion： For breast cancer women in child bearing age, breast-conserving surgery is similar to modified radical operation in regard to postoperative recurrence and metastasis, but the former is superior to the latter in respect to postoperative quality of life.