乳腔镜辅助保留乳头乳晕复合体的乳腺癌改良根治术安全性及改善生活质量作用分析

Oncological Safety and Quality of Life in Patients with Breast Cancer after Nipple-Areola-Complex Sparing Modified Mastoscopic Mastectomy

[目的]探讨乳腔镜辅助保留乳头乳晕复合体(NAC)的乳腺癌改良根治术(NSM)的肿瘤学安全性及在改善患者生活质量中的作用。[方法]收集294例乳腺癌患者的临床资料,其中乳腔镜辅助NSM观察组192例,同期行开放乳腺癌改良根治术(MRM)对照组103例,分析患者预后和生存情况,并采用乳腺癌患者生命质量测定量表(FACT-B)对两组患者生活质量进行测评。[结果]观察组复发转移29例,死亡11例,3、5年及总无病生存率(DFS)分别为95.0%、84%、84.9%,3、5年及总生存率(OS)分别98.3%、93.3%、94.3%;对照组复发转移12例,死亡5例,3、5年及总DFS分别为95.8%、93.2%、88.3%,3、5年及总OS分别为98.6%、93.2%、95.1%;两组DFS、OS差异均无统计学意义(P均>0.05)。除心理状况外,观察组患者生活质量各项指标均高于对照组患者(心理状况:18.800±4.383 vs 19.200±4.088,P=0.437;社会家庭状况:21.110±1.807 vs 20.640±1.862,P=0.034;情感状况:19.580±2.950 vs 17.350±2.367,P<0.001;功能状况:21.570±2.418 vs 20.89±2.191,P=0.018;附加关注:25.580±2.123 vs 21.900±2.286,P<0.001)。[结论]对于早期乳腺癌患者,乳腔镜辅助NSM可保证肿瘤学安全性,并提高术后生活质量。

[Objective]To analyze the oncological safety and the quality of life in patients with breast cancer following nipple-areola-complex(NAC)sparing modified mastoscopic mastectomy.[Methods]The clinical data of 294 patients with stageⅠ~ⅡA breast cancer were retrospectively analyzed,including 192 cases undergoing mastoscopyassisted nipple sparing mastectomy(NSM,study group),and 103 cases undergoing modified radical mastectomy(MRM,control group).The survival of patients was analyzed,and the quality of life was evaluated with breast cancer quality of life scale(FACT-B)in two groups.[Results]In study group there were 29 cases of recurrence and metastasis and 11 cases of death;while in control group,there were 12 cases of recurrence and metastasis and 5 cases of death.The 3-year,5-year and overall disease-free survival(DFS)in study and control groups were 95.0%,84.0%,84.9%,and 95.8%,93.2%,88.3%,respectively(all P>0.05).The 3-year,5-year,overall survival(OS)in study group and control group were 98.3%,93.3%and 94.3%,and 98.6%,93.2%,95.1%,respectively(all P>0.05).Except psychological status(18.800±4.383 vs 19.200±4.088,P=0.437),the quality of life indicators of the study group were significantly higher than those of the control group(social/family status:21.110±1.807 vs 20.640±1.862,P=0.034;emotional status:19.580±2.950 vs 17.350±2.367,P<0.001;functional status:21.570±2.418 vs 20.890±2.191,P=0.018;additional attention:25.580±2.123 vs 21.900±2.286,P<0.001).[Conclusion]Mastoscopy-assisted NSM can ensure oncological safety and improve quality of life in patients with early stage breast cancer.