早期乳腺癌保乳术与改良根治术疗效比较

An effect comparison between breast-conserving surgery and modified radical mastectomy in early breast cancer patients

目的探讨保留乳房的乳腺癌手术(以下简称保乳术)和乳腺癌改良根治术(以下简称改良根治术)治疗早期女性乳腺癌的临床疗效。方法收集2013-11至2016-12在武警总医院乳腺科就诊的120例女性早期乳腺癌患者的资料。根据手术方式将其分为保乳术组(n=66)和改良根治术组(n=54),比较两组的手术时间、住院时间、术中出血量、术后并发症发生率、术后局部复发率、转移率及病死/失访率。结果 (1)保乳术组平均手术时间(t=26.285,P<0.001)、术中出血量(t=45.651,P<0.001)、住院时间(t=21.840,P<0.001)均显著低于改良根治术组,差异均具有统计学意义。(2)保乳术组并发症发生率(1.5%vs 11.1%),复发率(3.0%vs 5.5%),转移率(3.0%vs 5.5%)均低于改良根治术组,但差异均无统计学意义;且两组均无病死/失访情况。(3)两组手术美容效果比较,保乳术组优、良率为83.33%(55/66),显著高于改良根治术组的55.56%(30/54),差异具有统计学意义(Z=-3.377,P<0.001)。结论保乳手术具有创伤小、恢复快、外观美容的优点,能显著提高早期乳腺癌患者生活质量,提高患者满意率。

Objective The objective of this study was to compare the effect between breast-conserving surgery and modified radical mastectomy in early breast cancer patients. Methods A total of 120 early breast cancer patients admitted into the General Hospital of Chinese People＇s Armed Police Force from November 2013 to December 2016 were analyzed retrospectively. Based on surgical mode, the patients were divided into the breast-conserving surgery group（n=66） and the modified radical mastectomy group（n=54）. The time taken for surgery, length of stay, average bleeding volume, the incidence of complications, local recurrence rate, metastasis rate, mortality rate and lost follow-up rate of the two groups were compared and analyzed. Results（1） The time taken for surgery（t=26.285, P〈0.001）, the length of stay（t=21.840, P〈0.001）, the average bleeding volume（t=45.651, P〈0.001） in the breastconserving group were significantly lower than those of modified radical group, the differences were statistically significant（P〈0.001）;（2） the incidence rate of complication（1.5% vs 11.1%）, the recurrence rate（3.0% vs 5.5%）, and metastasis rate（3.0% vs 5.5%） in the breastconserving group were lower than those of modified radical mastectomy group, the differences were not statistically significant; there was no mortality or loss of follow-up.（3） The eligible rate（83.33%） of breast-conserving surgery group was significantly higher than that of modified radical mastectomy group（55.56%）, the difference was statistically significant（P〈0.001）. Conclusions Breast-conserving surgery can cause minimal trauma, cosmetic appearance, and recover quickly, which can significantly improve the quality of life of early breast cancer patients.