保留乳头乳晕的改良根治术治疗早期乳腺癌的效果观察

Effects of nipple-sparing mastectomy in patients with early breast cancer

目的分析保留乳头乳晕的改良根治术(NSM)对早期乳腺癌患者甲状腺激素水平及复发率的影响.方法选择2014年4月至2019年4月滨州市中心医院收治的早期乳腺癌患者104例,以入院顺序奇偶数分为对照组和观察组,每组52例.对照组采用传统乳腺癌改良根治术治疗,观察组采用NSM术治疗,比较两组患者乳房外观美观优良率、并发症发生情况、甲状腺激素水平、生命质量测定量表(FACT-B)评分、远期转移率及3年后复发率.结果观察组乳房外观美观优良率(96.15%,50/52)高于对照组(76.92%,40/52),并发症发生率低于对照组,术后游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平高于对照组,治疗后1年FACT-B评分高于对照组,差异均有统计学意义(P均<0.05).两组术后远期转移率及3年后复发率比较差异未见统计学意义(P>0.05).结论NSM术与传统乳腺癌改良根治术治疗早期乳腺癌的远期疗效相当,但前者创伤性更小,并发症更少,对甲状腺激素的影响更小,美学程度更高.

Objective To analyze the effects of nipple-sparing mastectomy(NSM)in patients with early breast cancer.Methods A total of 104 patients with early breast cancer admitted to Binzhou Central Hospital from April 2014 to April 2019 were selected.The patients were divided into control group and observation group according to the odd and even number of admission sequence,with 52 cases in each group.The control group was treated by traditional modified radical mastectomy,while the observation group was treated by NSM.The excellent and good rate of breast appearance,complications,thyroid hormone level,functional assessment of Cciiieer therapy-breast(FACT-B)score,long-term metastasis rate and recurrence rate after 3 years were compared between the two groups.Results The excellent and good rate of Dreast appearance in the observation group(96.15%,50/52)was significantly higher than that in the control group(76.92%,40/52),and the incidence of complications was significantly lower than that in the control group(P<0.05).The levels of free triiodothyronine and free thyroxine in the observation group were significantly higher than those in the control group,and the FACT-B score was significantly higher than that in the control group 1 year after treatment(P<0.05).There was no significant difference in long-term metastasis rate and recurrence rate 3 years after operation between the two groups(P>0.05).Conclusions NSM tind Iraditional modified radical mastectomy have similar long-term efficacy in the treatment of early breast cancer,but the former has less trauma,fewer complications,less influence on thyroid hormones and higher aesthetic level,which is worthy of reference.