保乳术和改良根治术治疗年轻早期乳腺癌的疗效观察

Clinical analysis of breast-conserving surgery and modified radical mastectomy in treating young patients with breast cancer

目的探讨保乳手术和改良根治术治疗年轻早期乳腺癌的疗效对比研究。方法自2011年1月至2013年6月间70例年轻早期乳腺癌分为两组,保乳手术组(保乳组)和改良根治组(根治组),每组35例,对手术近期和远期疗效进行回顾性分析。采用SPSS13.0统计软件分析,手术时间、术中出血量、住院时间组间用t检验;术后生存率、局部复发率和远处转移率等用χ2检验,P<0.05为差异有统计学意义。结果保乳组的2年和5年生存率、局部复发率和远处转移率为100%、100%;0、11.4%;0、2.86%。根治组为100%、97.1%;0、8.57%;0、5.71%。两组比较差异均无统计学意义P>0.05。保乳组的手术时间、出血量、住院时间、并发症、上肢功能受限、形体美观、病员满意度为(95±22)min、(105±30)ml、(23.5±4.5)d、5.71%、2.8%、77.1%和94.3%,根治组为(145±28)min、(225±45)ml、(34.5±4.0)d、25.7%、20.0%、31.4%和48.6%;两组比较差异均有统计学意义,P<0.05,保乳组优于根治组。结论对年轻早期乳腺癌采用保乳手术联合综合治疗,具有操作简便、创伤小、恢复快,复发低、外观美容等优点,能显著提高患者的生活质量、不影响生存时间。

Objective To investigate the curative effect of breast-conserving surgery and modified radical mastectomy in treating young patients with breast cancer. Methods From January 2011 to June 2013, 70 young patients with early-staging breast cancer were randomly divided into two groups, including 35 patients who underwent breast-conserving surgery （ BCS group） and 35 patients who underwent modified radical mastectomy （MRM group）. Short-term and long-term clinical outcomes between the two groups were analyzed retrospectively by using SPSS13. 0 statistical software. Measurement data including average operative time, intraoperative blood loss, and hospital stay between the two groups were compared by Student＇s test,. The survival rate of the patients and the incidence of local recurrence and distant metastasis were evaluated by the chi-square test. P 〈 0.05 was considered statistically significant. Results The 2-year survival rate, 5-year survival rate, recurrence rate and distant metastasis rate in the BCS group was 100%, 100% , 11.4% , and 2.86% respectively whereas 100% ,97.1% , 8.57% , and 5.71% respectively in the MRM group （P 〉 0. 05 ）. In the BCS group, the operation time, amount of bleeding, hospital stay, complications, upper limb function limitation, body shape, and pathogenic satisfaction are （95 ± 22 ） min, （105±30） ml,（23.5 ±4.5） d, 5.71%, 2.8%, 77. 1% and 94.3% respectively, whereas （145 ± 28） min, （225 ±45） ml, （34.5±4.0） d, 25.7%, 20.0%, 31.4% and 48.6% in the MRM group （P 〈 0.05 ）. Conclusion In treating the young patients with early-staging breast cancer, BCS has such advantages as simple operation, mini-invasion, quick recovery, low recurrence rate, and satisfactory appearance, improved life quality, and the same survival time.