乳腺癌保留乳头改良根治术的前瞻性研究

A prospective study of nipple-preserving modified radical mastectomy for breast cancer

目的探讨乳腺癌保留乳头改良根治术的可行性以及美容效果。方法采用前瞻性随机对照研究方法,将2011年1月-2012年10月符合入组标准的40例乳腺癌患者随机分两组,研究组20例行乳腺癌保留乳头改良根治术,对照组20例行乳腺癌改良根治术,比较两组手术时间、术中出血量、术后引流量、并发症、肿瘤复发情况以及术后美容效果。结果两组手术时间、术中出血量、术后引流量、并发症比较差异无统计学意义(P>0.05);研究组20例保留乳头均成活,手术医生对乳房美容效果评价满意率80%(16/20);患者对胸部外形满意度的自我评分研究组明显优于对照组,差异有显著性统计学意义(P<0.01);两组患者随访12-33个月均无复发病例。结论乳腺癌保留乳头改良根治术安全可行,较传统改良根治术具有更佳的美容效果。

Objective To explore the feasibility and cosmetic effect of nipple-preserving modified radical mastectomy. Meth-ods By the method of prospective randomized comparison study,from January 2011 to October 2012,40 patients with breast can-cer were randomly divided into two groups,20 cases of study group accepted nipple-preserving modified radical mastectomy, 20 cases of control group accepted modified radical mastectomy. Then compare the two groups’ operative duration,blood loss, postop-erative flow rate,complications,local recurrence rate and cosmetic effect. Results Between the study group and control group,op-erative duration,blood loss,postoperative flow rate and complications of patients were all no statistical significance （P〉0.05）;Study group of 20 patients nipple preserving were all survived,the satisfaction rate assessed by operation doctors was 80%（16/20）;Obvi-ously,compared with the control group,the patients in the study group had better self-assessment of breast shape,the difference was statistical significance（P〈0.01）. The two groups of patients were followed up for 12 months-33months,neither with any recur-rence case. Conclusion Nipple-preserving modified radical mastectomy is safe and feasible,which has better cosmetic effect than mastectomy.