整形保乳术与改良根治术在早期乳腺癌患者中的应用价值探析

The Application Value of Plastic Breast-conserving Surgery and Modified Radical Mastectomy in Patients with Early Breast Cancer

目的:探究整形保乳术与改良根治术在早期乳腺癌患者中的应用价值。方法:回顾性分析2017年1月-2020年1月于笔者医院实施整形保乳术的64例Ⅰ~Ⅱ期乳腺癌患者临床资料,设为研究组;再选择同期行改良根治术的63例Ⅰ~Ⅱ期乳腺癌患者设为对照组。比较两组手术情况、术后6个月乳房美学效果及术前、术后6个月乳腺癌患者报告结局量表(Breast Questionnaire,BREAST-Q)评分情况,和术后1年根治效果。结果:研究组手术时间长于对照组,而术中出血量、术后引流量、住院时间均少于对照组,差异均有统计学意义(P<0.05)。两组术后6个月乳房美学效果总体差异显著,研究组优良率高于同期对照组,差异有统计学意义(P<0.05)。两组术后6个月BREAST-Q评分中躯体健康、社会心理健康、性健康得分均较术前下降,但研究组高于同期对照组,差异均有统计学意义(P<0.05)。术后1年两组复发率、转移率、生存率比较差异无统计学意义(P>0.05)。结论:整形保乳术较改良根治术会延长患者手术时间,但整形保乳术更有利于患者术后康复,且可有效维持患者乳房美学效果,对BREAST-Q评分影响更小,两种术式根治效果相近。

Objective To explore the clinical application value of plastic breast-conserving surgery and modified radical mastectomy in patients with early breast cancer.Methods A retrospective analysis was performed on the clinical data of 64 patients with stageⅠ-Ⅱbreast cancer who underwent plastic breast-conserving surgery in the hospital between January 2017 and January 2020,and the patients were selected as the study group.And 63 patients with stageⅠ-Ⅱbreast cancer who came to the hospital for modified radical mastectomy during the same period were included in the control group.The operation condition,breast aesthetic effect at 6 months after surgery,BREAST-Q score at before and 6 months after surgery,and radical cure effect at one year after surgery were compared between the two groups.Results The surgical time of the study group was longer than that of control group,but the intraoperative blood loss,postoperative drainage volume and hospital stay of the study group were less or shorter than those of the control group(P<0.05).At 6 months after surgery,there was a significant difference in the overall breast cosmetic effect between the two groups,and the excellent and good rate of the study group was higher than that of the control group during the same period(P<0.05).At 6 months after surgery,the scores of physical health,social mental health and sexual health of BREAST-Q in the two groups of patients were decreased compared with those before surgery,but the scores were higher in the study group than those in the control group during the same period(P<0.05).At one year after surgery,there were no significant differences in recurrence rate,metastasis rate and survival rate between the two groups(P>0.05).Conclusion Plastic breast-conserving surgery will prolong the operation time of patients compared with modified radical mastectomy,but plastic breast-conserving surgery is more conducive to postoperative recovery,and can effectively maintain the breast cosmetic effect and has less impact on BREAST-Q scores.In addition,the two surgical methods have the similar radical treatment effect on patients.