环乳晕入路保留乳头乳晕乳腺癌改良根治术治疗早期乳腺癌的疗效观察

Efficacy of modified circumareolar radical mastectomy with nipple-areola complex preservation for early-stage breast cancer

目的探讨环乳晕入路保留乳头乳晕乳腺癌改良根治术治疗早期乳腺癌的疗效。方法本研究选取2017年5月—2019年4月在河南省某医院收治的90例早期乳腺癌患者作为研究对象。采用随机数字表法将患者分为观察组和对照组,各45例。对照组患者给予常规乳腺癌根治术,观察组患者给予环乳晕入路保留乳头乳晕乳腺癌改良根治术。采用美国芝加哥医学中心研制的《乳腺癌生存质量测评表(FACT-B)》对2组患者出院时的生活质量进行评估。比较2组患者出院2年时局部复发、远处转移和生存情况。比较2组患者术后至出院时并发症发生情况。结果术前2组患者FACT-B评分比较,差异无统计学意义(P<0.05)。出院时,2组患者FACT-B中心理、社会、精神、躯体维度评分分别为(114.32±37.41)分、(50.02±19.45)分、(41.51±13.66)分、(57.78±17.96)分,均高于对照组的(98.62±32.89)分、(40.32±17.22)分、(31.45±11.13)分、(50.34±15.56)分,差异均有统计学意义(P<0.05)。2组患者局部复发率、远处转移率和生存率比较,差异无统计学意义(P>0.05)。观察组患者并发症发生率为6.66%,低于对照组的22.20%,差异有统计学意义(P<0.05)。结论环乳晕入路保留乳头乳晕乳腺癌改良根治术在治疗早期乳腺癌中有良好的疗效,能够提高患者的生存质量,降低术后并发症发生率,是一种安全、有效、科学的治疗方式,值得临床推广应用。

Objective To investigate the efficacy of a modified circumareolar radical mastectomy with nipple-areola complex preservation for early-stage breast cancer.Methods Ninety cases of early-stage breast cancer patients admitted to a hospital in Henan Province from May 2017 to April 2019 were enrolled for this study.A random number table was used to divide the patients into observation group and control group,45 cases each.Patients in the control group were given conventional radical mastectomy for breast cancer,and patients in the observation group were given modified circumareolar radical mastectomy with nipple-areola complex preservation.The quality of life at the time of discharge was assessed according to the Functiond Assessment of Cancer Therapy-Breast(FACT-B)developed by the Chicago Medical Center,USA.Local recurrence,distant metastasis and survival were compared between the 2 groups of patients at 2 years of hospital discharge.The occurrence of complications from postoperative period to hospital discharge was compared between the 2 groups of patients.Results Preoperative FACT-B scores of patients in the 2 groups were compared,and the difference was not statistically significant(P<0.05).At the time of discharge,the scores of psychological,social,spiritual and somatic dimensions in the FACT-B of patients in the observation group were 114.32±37.41,50.02±19.45,41.51±13.66 and 57.78±17.96,respectively,which were higher than those of the control group at 98.62±32.89,40.32±17.22,31.45±11.13 and 50.34±15.56,with statistically significant differences(P<0.05).There was no statistically significant difference between the local recurrence rate,distant metastasis rate and survival rate of the 2 groups(P>0.05).The complication rate of patients in the observation group was 6.66%,which was lower than that of 22.20%in the control group,and the difference was statistically significant(P<0.05).Conclusion The modified circumareolar radical mastectomy with nipple-areola complex preservation has good efficacy in the treatment of breast cancer,which can improve the survival quality of patients and reduce the incidence of postoperative complications,and is a safe,effective and scientific treatment method that is worthy of wider clinical practice.