乳腺癌保乳手术切缘与瘤体距离对切缘状态及美容效果的影响

Effects of different tumors resection margin status from breast conserving surgery and cosmetic results

目的分析乳腺癌保乳手术切缘与瘤体距离对切缘状态及术后美容效果的影响。方法116例乳腺癌行保乳手术治疗患者的一般资料、手术方法,根据切缘与瘤体距离不同分为A组（瘤距1 cm）和B组（瘤距2 cm）,A组63例,B组53例,比较两组患者的切缘阳性率、术后美容效果,随访2~5年,观察患者的近期复发率及生存质量的差异。结果 A组患者术中切缘阳性率为3.2%,B组患者为1.9%,但差异无统计学意义（P〉0.05）。A组患者美容效果优良率为73.0%,B组患者为43.4%,差异有统计学意义（P〈0.05）。术后2年,A组患者心理、精神维度及总分高于B组患者,差异均有统计学意义（P〈0.05）,术后随访2~5年,A组患者2年复发率和5年复发率分别为4.8%和5.7%,B组患者分别为3.8%和7.4%,差异无统计学意义（P〉0.05）。结论在确保切缘阴性的基础上,切缘与瘤缘距离为1 cm能够在保证术后高生存率及低复发率的基础上,提供良好的美容效果,改善患者术后生存质量,是较为理想的瘤距选择。

Objective To observe the analysis of breast conserving surgery and tumor margin from different tumor margin statuses and its influence on postoperative cosmetic results.Methods A retrospective analysis of 116 cases of breast cancer breast conserving surgery patients in this study,analyze its general information,surgical methods,depending on the distance of the tumor margin and were divided into group A（aneurysm from 1 cm） 63 examples and group B（tumor from 2 cm） 53 patients were compared positive margin rate,postoperative cosmetic results,followed up for 2 to 5 years,recently observed different in relapse rate and quality of life.Results A group of intraoperative surgical margin status pathological positive rate of 3.2%,1.9%,slightly higher than group B,but no significant difference（P 〉 0.05）,excellent cosmetic result was 73.0%,higher than 43.4% in the control group,the difference was statistically significant（P 〈 0.05）,after 2 years of group A in the psychological and spiritual dimensions,and scores higher than group B,the differences were statistically significant（P 〈 0.05）,postoperative follow-up of 2 to 5 years,2-year recurrence rate was no significant difference between 5-year recurrence rate（A group of 4.8%,5.7%,group B of 3.8%,7.4%,P 〉 0.05）.Conclusion On the basis of ensuring the cut edge negative,cutting edge and the tumor edge distance range of 1 cm could ensure high postoperative survival rate and low recurrence rate,and can provide good cosmetic effect and improve the patients quality of life.So it is the ideal choice for breast cancer patients.