保乳联合前哨淋巴结活检术的疗效及安全性研究

Research on the efficacy and safety of breast-conserving combined with sentinel lymph node biopsy

目的比较保乳(BCS)联合前哨淋巴结活检术(SLNB)与改良根治术(MRM)治疗乳腺癌的疗效及安全性。方法选取2013年10月至2020年12月于承德医学院附属医院乳腺外科收治的符合保乳标准的211例原发早期乳腺癌患者。应用BCS联合SLNB的106例患者为观察组;同期符合保乳标准,但拒绝行BCS联合SLNB的105例患者行MRM治疗,为对照组。比较两组术后肩关节活动情况,患者对手术美容效果的满意程度、心理健康影响,术后患者总生存情况。结果观察组术后患侧肩关节活动、乳房美容效果的满意程度、心理健康情况均优于对照组,差异有统计学意义(P<0.05)。观察组患者总生存情况与对照组比较,差异无统计学意义(P>0.05)。结论对于早期乳腺癌患者而言,BCS联合SLNB较MRM术后肩关节活动较好、拥有更佳的术后美容效果,且安全性相当。

Objective To compare the advantages and disadvantages and research the efficacy and safety of breastconserving(BCS)therapy combined with sentinel lymph node biopsy(SLNB)and modified radical mastectomy(MRM)in the treatment of breast cancer.Methods A total of 211 patients with primary early breast cancer who met the standard of BCS admitted to and treated in the department of breast surgery of the Affiliated Hospital of Chengde Medical University from October 2013 to December 2020 were enrolled into the observation group(n=106)and the control group(n=105).The observation group was treated with BCS combined with SLNB,while in the same period,the control group who met the standard of BCS but refused to be treated with BCS combined with SLNB was treated with MRM.The postoperative activity of shoulder joint,the satisfaction of patients with cosmetic effect of surgery and the impact on mental health and the overall survival of patients after surgery were compared between the two groups.Results The postoperative activity of shoulder joint,the satisfaction of patients with breast cosmetic effect and the mental health in the observation group were superior to those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the patients'overall survivals between the observation group and the control group(P>0.05).Conclusion For patients with early breast cancer,BCS combined with SLNB has better postoperative activity of shoulder joint,superior postoperative cosmetic effect and equal safety to MRM.