保乳术联合前哨淋巴结活检对乳腺癌患者近期疗效及乳房美观度的影响

Effects of Breast-conserving Surgery Combined with Sentinel Lymph Node Biopsy on Short-Term Effi cacy and Breast Aesthetics in Patients with Breast Cancer

目的:探究保乳术联合前哨淋巴结活检对乳腺癌患者近期疗效及乳房美观度的影响。方法:回顾性分析2019年1月-2021年12月于笔者医院就诊的采用改良根治术联合腋窝淋巴结清扫术治疗的乳腺癌患者临床资料,随机选取84例纳入对照组;回顾性分析同期于笔者医院就诊的采用保乳术联合前哨淋巴结活检进行治疗的乳腺癌患者临床资料,随机选取76例纳入研究组。统计两组患者手术指标(手术时长、术中出血量、腋窝拔管时间),比较两组患者术后6个月近期疗效,记录两组患者术前及术后6个月肩关节活动度(外展、内旋、后伸、屈曲度)、生活质量[乳腺癌生活质量调查问卷(Quality of life questionnaire breast module,QLQ-BR23)、乳腺癌生活质量测定表(Functional assessment of cancer therapy-breast,FACT-B)、创伤后应激障碍筛查量表(Post-traumatic stress disorder checklist-civilian version,PCL-C)],并于两组患者术后6个月评价其乳房美观度(乳房美学评分),记录两组患者术后6个月内并发症发生情况。结果:术后,研究组患者术中出血量少于对照组,手术时长、腋窝拔管时间均短于对照组,肩关节活动度高于对照组,QLQ-BR23、PCL-C评分低于对照组,FACT-B评分高于对照组,患者乳房美观度优良率高于对照组,以上指标组间比较差异均有统计学意义(P<0.05);但两组患者治疗有效率及并发症总发生率比较差异无统计学意义(P>0.05)。结论:保乳术联合前哨淋巴结活检与改良根治术联合腋窝淋巴结清扫术具有相近的治疗效果,但进行保乳术联合前哨淋巴结活检的患者术后恢复更快,且该术式对患者肩关节活动度、乳房美观度及日常生活质量影响更小。

Objective To explore the eff ects of breast-conserving surgery combined with sentinel lymph node biopsy on short-term effi cacy and breast aesthetics in patients with breast cancer.Methods Clinical data of patients with breast cancer who were treated with modifi ed radical surgery combined with axillary lymph node dissection in the hospital from January 2019 to December 2021 were retrospectively analyzed,and 84 cases were randomly selected and included in control group.Clinical data of patients with breast cancer who received breast-conserving surgery combined with sentinel lymph node biopsy in the hospital were retrospectively analyzed during the same period,and 76 cases were randomly enrolled as study group.The surgical indicators(surgical duration,intraoperative blood loss,axillary extubation time)of the two groups were statistically analyzed,and the short-term efficacy at 6 months after surgery was compared between the two groups.Shoulder ranges of motions(abduction,pronation,rear protraction,fl exion)and quality of life[quality of life questionnaire breast module(QLQ-BR23),functional assessment of cancer therapy-breast(FACT-B),post-traumatic stress disorder checklist-civilian version(PCL-C)]were recorded inboth groupsbefore surgery and at 6 months after surgery.The breast aesthetics(breast aesthetics score)of the two groups was evaluated at 6 months after surgery,and the occurrence of complications in the two groups were recorded within 6 months after surgery.Results After surgery,the intraoperative blood loss in the study group was less than that in the control group,the operation duration and axillary extubation time were shorter than that in the control group,the shoulder joint mobility was higher than that in the control group,the QLQ-BR23 and PCL-C scores were lower than those in the control group,and the FACT-B scores were higher than those in the control group.There were statistically signifi cant diff erences among the above indexes(P<0.05).However,there was no signifi cant diff erence in treatment eff ectiveness and total complication rate between the two groups(P>0.05).Conclusion Breast-conserving surgery combined with sentinel lymph node biopsy has similar therapeutic eff ects as modifi ed radical surgery combined with axillary lymph node dissection.However,breast-conserving surgery combined with sentinel lymph node biopsy has a rapid postoperative recovery and has smalleff ects onshoulder ranges of motions,breast aesthetics and daily life quality.