MRI在乳腺癌保乳手术中的应用

MRI in Breast-conserving Surgery for Breast Cancer

目的探讨MRI在乳腺癌保乳手术中的应用价值。资料与方法回顾性分析2015年6月3日-2018年1月30日于安徽医科大学第一附属医院行保乳手术并完成随访的109例乳腺癌患者的临床资料,其中术前行乳腺MRI检查者52例(研究组),未行乳腺MRI检查者57例(对照组)。所有患者经常规检查均适合行保乳术。比较两组患者切缘阳性率、再手术率及手术变更率之间的差异;测量研究组患者的肿瘤/乳腺体积比。结果研究组与对照组患者切缘阳性率差异无统计学意义(15.4%比15.8%,P>0.05)。研究组2例保乳患者于术后次月分别行改良根治术及单纯乳房切除术;对照组无再手术患者。研究组与对照组患者的手术变更率差异无统计学意义(9.6%比12.3%,P>0.05)。肿瘤/乳腺体积比在手术切缘阴性及切缘阳性中差异均有统计学意义(P<0.05)。结论乳腺癌保乳手术前行MRI检查不能有效降低乳腺癌患者的切缘阳性率、再手术率及手术变更率,但MRI检查测量的肿瘤/乳腺体积比是切缘阳性率的影响因素。

Purpose To explore the value of MRI in breast-conserving surgery for breast cancer.Materials and Methods One hundred and nine patients with breast cancer who received breast-conserving surgery in the First Affiliated Hospital of Anhui Medical University from June3,2015to January30,2018were retrospectively analyzed.Among them,52patients underwent breast MRI examination before operation(study group)and57patients didn’t undergo breast MRI examination before operation(control group).All the patients were suitable for breast-conserving surgery evaluated by routine examinations.The rate of positive margin,reoperation rate and surgical change rate were compared between the two groups;the volume ratio of tumor to breast was measured for the patients in study group.Results There was no statistically significant difference in the rate of positive margin between study group and control group(15.4%vs.15.8%,P>0.05).In study group,2patients underwent modified radical mastectomy and simple mastectomy in the following month after breast-conserving surgery;while there was no reoperation in control group.The surgical change rate in the two groups was respectively9.6%and12.3%,without statistical significance(P>0.05).There was a statistically significant difference in the volume ratio of tumor to breast between negative margins and positive margins(P<0.05).Conclusion The MRI examination before breast-conserving surgery cannot effectively reduce the rate of positive margin,reoperation rate and surgical change rate for patients with breast cancer,but the volume ratio of tumor to breast measured by MRI is an influencing factor of positive margin rate.