乳腺癌保乳手术后局部凹陷的原因分析

Causes of local depression in breast cancer after breast conserving surgery

目的探析乳腺癌保乳手术后局部凹陷的原因,减少乳腺癌保乳手术后对乳房外形的不利影响,提高患者生活质量。方法根据保乳术后是否出现乳房局部凹陷现象将2015年1月-2016年12月来该院进行保乳手术治疗的120例乳腺癌患者分为对照组和观察组。发生乳房凹陷现象患者43例入观察组,未发生乳房凹陷现象患者77例入对照组。120例患者均行腋窝淋巴结清扫,腋窝及乳房创面常规放引流,两组患者均保证手术切缘阴性。分析比较手术切口、切除范围、创腔处理及术后放化疗与患者保乳手术后乳房局部凹陷的关系。结果将肿瘤切除和腋窝清扫分别做切口的患者乳房局部凹陷率明显低于做一切口的患者乳房局部凹陷率,比较差异有统计学意义(P<0.05);过大范围的乳腺切除与乳房局部凹陷具有一定关系。结论保乳术治疗过程中手术切口、切除范围与乳房局部凹陷具有相关性,临床应加强其影响因素监测评估,以便于及时有效采取干预措施,提高治疗效果,降低乳房畸形率。

【Objective】To probe into the causes of local depression in breast cancer after breast conserving surgery, to reduce the adverse effects on breast shape after breast conserving surgery, and to improve the quality of life of the patients.【Methods】A total of 120 patients with breast cancer who underwent the breast conserving surgery in our hospital from January 2015 to December 2016 were divided into the control group and the observation group according to whether there was local depression in the breast after breast conserving surgery. Forty-three patients with the breast depression were treated as the observation group, while 77 cases without the breast depression were treated as the control group. One hundred and twenty cases underwent the axillary lymph node dissection and routine drainage of the axillary and breast wounds. Patients in the two groups were all ensured that the surgical margin was negative. Then, the relationship between surgical incision, resection range, cavity treatment, postoperative radiotherapy and chemotherapy and breast local depression after breast conserving surgery were compared and analyzed.【Results】The local depression rate of the patients with tumor resection and axillary dissection was significantly lower than that of the patients who underwent single incision, and there was significant difference（P〈0.05）. There was certain relationship between overlarge mammary resection and local depression of the breast.【Conclusion】In the course of breast conserving surgery, the incision, the range of resection and the local depression of the breast are related, and it is necessary to strengthen the monitoring and evaluation of its influencing factors in order to facilitate the timely and effective intervention measures, improve the effect of treatment and reduce the rate of breast deformity.