环乳晕入路保留乳头乳晕乳腺癌改良根治术治疗乳腺癌的效果及安全性分析

Analysis of the effect and safety of modified radical mastectomy for breast cancer with preserving nipple and areola via circular areola approach in treatment of breast cancer

目的分析环乳晕入路保留乳头乳晕乳腺癌改良根治术治疗乳腺癌的效果及安全性。方法选取2015年3月至2016年3月本院收治的82例乳腺癌患者作为研究对象,按照随机数奇偶法分为A组与B组,每组41例。A组应用传统乳腺癌改良根治术治疗,B组应用环乳晕入路保留乳头乳晕乳腺癌改良根治术治疗,比较两组手术指标(手术时间、术中出血量、淋巴结清扫数目、术后引流量、住院时间)、临床疗效、并发症发生情况、上肢功能、乳房美观效果、生命质量及预后情况。结果B组手术时间长于A组,术中出血量多于A组,术后引流量少于A组,住院时间短于A组,差异有统计学意义(P<0.05)。两组缓解率比较差异无统计学意义。两组并发症发生率比较差异无统计学意义。B组术后上肢、肩、手功能障碍评定量表(DASH)评分低于A组,差异有统计学意义(P<0.05)。B组乳房美观优良率高于A组,差异有统计学意义(P<0.05)。B组术后的乳腺癌生存质量量表(Fact-B)评分高于A组,差异有统计学意义(P<0.05)。两组局部复发率与无病生存率比较差异无统计学意义。结论环乳晕入路保留乳头乳晕乳腺癌改良根治术治疗乳腺癌的疗效确切,可改善手术指标,提高上肢功能,乳房美观效果好,患者术后生存质量佳,值得临床推广应用。

Objective To analyze the effect and safety of modified radical mastectomy for breast cancer with preserving nipple and areola via circular areola approach in treatment of breast cancer.Methods A total of 82 breast cancer patients admitted to our hospital from March 2015 to March 2016 were selected as the research subjects,and they divided into the group A and the group B according to the random number parity method,with 41 cases in each group.The group A was modified with traditional breast cancer for radical mastectomy,the group B was treated with modified radical mastectomy for breast cancer with preserving nipple and areola via circular areola approach.The surgical indicators(operating time,intraoperative blood loss,number of lymph node dissections,postoperative drainage,and hospitalization time)and clinical efficacy,complications,upper limb function,breast aesthetics,quality of life and prognosis were compared between the two groups.Results The operation time in the group B was longer than that in group A,the intraoperative blood loss was more than that in group A,the postoperative drainage less than that in the group A,and hospitalization time was shorter than that in group A,the differences were statistically significant(P<0.05).There was no significant difference in remission rate between the two groups.There was no significant difference in the incidence of complications between the two groups.The postoperative disabilities of arm,shoulder and hand scale(DASH)score in the group B was lower than that in the group A,the difference was statistically significant(P<0.05).The excellent and good rate of breast aesthetic effect in the group B was higher than that in the group A,and the difference was statistically significant(P<0.05).The postoperative functional assessment of cancer therapy-breast(Fact-B)score in the group B was higher than that in the group A,and the difference was statistically significant(P<0.05).There were no significant differences in local recurrence rate and disease-free survival rate between the two groups.Conclusion The curative effect of modified radical mastectomy for breast cancer with preserving the nipple and areola of the circular areola approach is definite in the treatment of breast cancer,it can improve the surgical index,improve the function of the upper limbs,and have good breast beauty effect,and the postoperative quality of life is good,is worthy of clinicial promotion and application.