保乳术与改良根治术联合背阔肌乳房成形术的临床疗效分析

Comparison between breast-conserving therapy and real-time reconstruction using latissimus dorsi flap after modified radical mastectomy in early-stage breast cancer patients

目的：比较早期乳腺癌患者保乳手术和改良根治术联合背阔肌瓣乳房成形术的疗效，并对两者的预后相关因素进行分析。方法：回顾性分析2000年1月∽2013年1月我院收治实施保乳手术（121例）及改良根治术联合背阔肌瓣乳房成形术（105例）的早期乳腺癌患者临床病理资料，比较复发率、生存率以及在院期间的相关指标。结果：（1）与改良根治术联合背阔肌瓣乳房成形术组相比，保乳术组的手术时间和住院时间明显缩短、术中出血量显著减少、相关术后并发症发生率也更低，组间存在显著差异（P＜0．05）。（2）保乳组：3年同5年复发率分别为3．31％和9．91％。总生存率达到89．3％。改良根治术联合背阔肌瓣乳房成形术组：3年同5年复发率分别为4．76％和12．38％。总生存率达到89．5％；且对2组进行比较后均无显著性差异（ P均＞0．05）。结论：早期乳腺癌患者的保乳手术与改良根治术联合背阔肌瓣乳房成形术在复发率及生存率等方面无显著性差异。但与后者比较，保乳术具有术中打击小，术后恢复快，并发症少等优势，是早期乳腺癌患者的首选。

Objective：To analyze the therapeutic of comparion between the breast -conserving therapy （ BCT） and real-time recon-struction using latissimus dorsi flap after modified radical mastectomy （ MRM） forpatientswith early -stage breast cancer .Methods：The clinicopathologic data of young women with breast cancer who had undergone BCT （121） and MRM（105 cases） in our hospital, during a period from January 2000 to January 2013, was retrospectively analyzed .Operation time, hospitalization time, blood loss during surgery , relapseand survivals of the patients between the two groups were compared .Results：In the breastconservation group , the 3-year tumor-free relapse rate was 3.31%, the 5-year tumor-free relapse rate was 9.91%, and the overal survival rate was89.3%.In the modified-surgery group, the 3-year tumor-free relapse rate was 4.76%, the 5-year tumor-free relapse rate was 12.38%, and the overall sur-vival rate was 89.5%.The above differences were no statisticalbetween the two groups （P〉0.05）.However, there were significant differences in operation time , hospitalization time , blood loss during surgery and so on between the above two .Conclusion：There were no apparent statistical differences in the comparison of the relapse and survival rates between the two groups .However , due to shorter opera-tion time and hospitalization time , less blood loss during surgery , lower incidence rate of postoperative complication , better postoperative cosmeticresults , BCT should be preferred for patients with early -stage breast cancer .