保乳手术与改良根治术治疗早期乳腺癌患者的效果比较

Comparison of effects of breast conserving surgery and modified radical mastectomy in treatment of patients with early breast cancer

目的:比较保乳手术与改良根治术治疗早期乳腺癌患者的效果。方法:回顾性分析2017年3月至2020年3月该院收治的80例早期乳腺癌患者的临床资料,按治疗方法不同将其分为对照组与观察组各40例。对照组采用改良根治术治疗,观察组采用保乳手术治疗,比较两组手术相关指标水平、手术前后血清肿瘤标志物[糖类抗原153(CA153)、癌胚抗原(CEA)、血管内皮生长因子(VEGF)]水平、并发症发生率、术后乳房美观度优良率、手术前后婚姻质量(Olson婚姻质量问卷)评分,以及局部复发率和远转移发生率。结果:两组手术时间和淋巴结清扫个数比较,差异无统计学意义(P>0.05);观察组手术出血量少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05);术后1周,两组CA153、CEA、VEGF水平均低于术前,但组间比较,差异无统计学意义(P>0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组乳房美观度优良率高于对照组,差异有统计学意义(P<0.05);术后6个月及1年,两组夫妻交流、夫妻性生活、婚姻满意度等Olson婚姻质量问卷评分均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05);两组局部复发率和远处转移率比较,差异均无统计学意义(P>0.05)。结论:保乳手术治疗早期乳腺癌患者可减少手术出血量,缩短住院时间,降低并发症发生率,提高乳房美观度优良率和Olson评分,其效果优于改良根治术治疗。

Objective:To compare effects of breast conserving surgery and modified radical mastectomy in treatment of patients with early breast cancer.Methods:The clinical data of 80 patients with early breast cancer admitted to this hospital from March 2017 to March 2020 were retrospectively analyzed.They were divided into control group and observation group according to different treatment methods,40 cases in each group.The control group was treated with modified radical mastectomy,while the observation group was treated with breast conserving surgery.The surgery-related indicator levels,the serum tumor marker levels[carbohydrate antigen 153(CA153),carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF)]before and after the surgery,the incidence of complications,the excellent and good rate of postoperative breast aesthetic,the quality of marriage before and after the surgery(Olson marital quality questionnaire)score,and the incidence of local recurrence and distant metastasis were compared between the two groups.Results:There were no significant differences in the operation time and the number of lymph node dissected between the two groups(P>0.05).The amount of bleeding in the observation group was less than that in the control group,the hospitalization time was shorter than that in the control group,and the differences were statistically significant(P<0.05).1 week after the surgery,the levels of CA153,CEA,and VEGF in both groups were lower than before the surgery,but there were no statistically significant differences between the groups(P>0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The excellent and good rate of breast aesthetics in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).6 months and 1 year after the surgery,the scores of Olson marital quality questionnaire such as marital communication,marital sexual life and marital satisfaction in the two groups were lower than those before the surgery,but those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).However,there were no significant differences in the local recurrence rate and the distant metastasis rate between the two groups(P>0.05).Conclusions:Breast-conserving surgery for the patients with early breast cancer can reduce the amount of bleeding,shorten the hospitalization time,reduce the incidence of complications,and improve the excellent and good rate of breast aesthetics and the Olson scores.Moreover,it is superior to modified mastectomy treatment.