保留乳头乳晕青年乳腺癌改良根治术后即刻乳房再造临床研究

Clinical study of immediate breast reconstruction after modified radical mastectomy for young breast cancer with nipple-preserving and areola

目的探讨保留乳头乳晕青年乳腺癌改良根治术后即刻乳房再造对患者临床预后、生存质量的影响。方法回顾性分析2016年1月至2018年3月青年乳腺癌患者71例患者资料,按照术式不同分为观察组36例和对照组35例。对照组采用保留乳头乳晕乳腺癌改良根治术,观察组采用保留乳头乳晕乳腺癌改良根治术后即刻乳房再造治疗,术后对所有患者进行随访。采用SPSS 19.0统计学软件分析,手术相关指标、生命质量测定量表(FACT-B)评分等计量资料以(±s)表示,独立t检验;局部复发和远处转移率采用χ^(2)检验,P<0.05表示差异有统计学意义。结果观察组患者手术时间、术中出血量多于对照组(P<0.05);两组淋巴结清扫数目比较差异无统计学意义(P>0.05)。术后1年,两组患者FACT-B评分均升高,且观察组FACT-B评分高于对照组(P<0.05)。观察组局部复发率为8.3%、远处转移率为6.7%,对照组局部复发率为10.0%、远处转移率为10.0%;两组患者局部复发率和远处转移率比较差异无统计学意义(P>0.05)。结论保留乳头乳晕改良根治术后即刻乳房再造可维持乳腺癌患者乳房原有外形,并能提高患者术后生存质量,且短期内不会增加局部复发、远处转移的风险。

Objective To explore the effect of immediate breast reconstruction after modified radical mastectomy on the clinical prognosis and quality of life of breast cancer patients.Methods Data of 71 young breast cancer patients from January 2016 to March 2018 were retrospectively analyzed,according to different surgical methods,they were divided into observation group(n=36)and(n=35)control group.The control group was treated with modified radical mastectomy with sparing nipple and areola,and the observation group was treated with immediate breast reconstruction after modified radical mastectomy with sparing nipple and areola.All patients were followed up.The SPSS 19.0 statistical software was used for analysis,Surgical indicators,FACT-B score and other measurement data were represented by(±s),independent t-test was performed;local recurrence and distant metastasis rates were byχ^(2) test,and P<0.05 indicated statistically significant differences.Results The operation time and intraoperative blood loss in observation group were longer than those in control group(P<0.05).There was no significant difference in the number of dissected lymph nodes between the two groups(P>0.05).One year after surgery,FACT-B scores was increased in both groups,and the observation group FACT-B scores was higher than control group(P<0.05).The observation group local recurrence rate was 8.3%,the distant metastasis rate was 6.7%,and 10.0%and 10.0%in the control group.There was no significant difference in local recurrence rate and distant metastasis rate between 2 groups(P>0.05).Conclusion Immediate breast reconstruction after modified radical mastectomy with sparing nipple and areola can maintain the original shape of breast,effectively improve the quality of life of patients after operation,without increasing the risk of local recurrence and distant metastasis in the short term.