观察保乳术与改良根治术治疗早期乳腺癌的临床疗效

Observation on clinical efficacy of breast conserving surgery and modified radical mastectomy in the treatment of early breast cancer

目的分析保乳术与改良根治术治疗早期乳腺癌的临床疗效。方法 60例早期乳腺癌患者,采用随机抽签的方式分为甲组和乙组,各30例。甲组采用保乳术治疗,乙组采用改良根治术治疗。比较两组患者术后2年生存情况、远处转移情况、腋窝淋巴结复发情况、局部复发情况、术后并发症发生情况及切口长度、手术时间、住院时间、术中出血量,观察两组患者乳房美容效果。结果甲组患者切口长度、手术时间和住院时间均短于乙组,术中出血量少于乙组,差异有统计学意义(P<0.05)。两组患者术后2年生存率、远处转移率、腋窝淋巴结复发率、局部复发率、术后并发症发生率比较差异无统计学意义(P>0.05)。甲组患者术后乳房美容效果优16例,良12例,差2例,优良率为93.3%;乙组患者术后乳房美容效果优11例,良11例,差8例,优良率为73.3%;甲组优良率高于乙组,差异有统计学意义(P<0.05)。结论保乳术与改良根治术治疗早期乳腺癌均有较好的临床疗效,但保乳术对患者的创伤更小,术后恢复更快,乳房美容效果更好,综合比较更具优势。

Objective To analyze the clinical efficacy of breast conserving surgery and modified radical mastectomy in the treatment of early breast cancer.Methods A total of 60 early breast cancer patients were divided by random lottery method into group A and group B,with 30 cases in each group.Group A was treated with breast conserving surgery,and group B was treated with modified radical mastectomy.Comparison were made on postoperative 2-year survival status,distant metastasis,axillary lymph node recurrence,local recurrence,postoperative complications,incision length,operation time,hospitalization time,and intraoperative bleeding volume between two groups,and observation was made on cosmetic effects of breast.Results Group A had shorter incision length,operation time,hospitalization time than group B,and less intraoperative bleeding volume than group B.Their difference was statistically significant（P0.05）.Both groups had no statistically significant difference in postoperative 2-year survival rate,distant metastasis,axillary lymph node recurrence rate,local recurrence rate,postoperative complications rate（P0.05）.Group B had 16 excellent cases in cosmetic effects of breast,12 good cases and 2 poor cases,with excellent-good rate as 93.3%,while group B had 11 excellent cases in cosmetic effects of breast,11 good cases and 8 poor cases,with excellent-good rate as 73.3%.Group A had higher excellent-good rate than group B,and the difference was statistically significant（P0.05）.Conclusion Both breast conserving surgery and modified radical mastectomy shows good clinical efficacy in treating early breast cancer,but breast conserving surgery has more advantages by comprehensive comparison of smaller trauma,faster recovery after operation and better cosmetic effects of breast.