目的:分析乳腺旋切微创术治疗多发性乳腺纤维瘤的疗效及美容效果。方法:选取2019年3月~2020年9月收治的104例多发性乳腺纤维瘤患者,随机分为微创组和传统组各52例。微创组接受乳腺旋切微创术治疗,传统组接受传统乳腺纤维瘤切除术治疗。...目的:分析乳腺旋切微创术治疗多发性乳腺纤维瘤的疗效及美容效果。方法:选取2019年3月~2020年9月收治的104例多发性乳腺纤维瘤患者,随机分为微创组和传统组各52例。微创组接受乳腺旋切微创术治疗,传统组接受传统乳腺纤维瘤切除术治疗。对比两组手术相关指标(术中出血量、手术时间、切口直径、切口愈合时间)、疼痛评分、并发症情况和美容效果评分。结果:微创组术中出血量低于传统组,手术时间、切口直径、切口愈合时间短于传统组(P<0.05);微创组术后局部血肿和出血发生率低于传统组(P<0.05),两组术后局部感染发生率对比无统计学差异(P>0.05);微创组术后6 h、12 h、24 h VAS评分均低于传统组(P<0.05);随访1个月,微创组美容效果评分(乳头乳晕感觉、乳房形状、乳房切口瘢痕、色素沉着)均高于传统组(P<0.05)。结论:乳腺旋切微创术可明显缩短乳腺纤维瘤患者手术时间、切口直径和切合愈合时间,减少术中出血量,减轻术后疼痛,提高术后乳房美容效果,降低术后并发症发生风险。展开更多
Objective: Survival and treatment of patients with microinvasive breast cancer(MIBC) remain controversial. In this paper, we evaluated whether adjuvant chemotherapy is necessary for patients with MIBC to identify risk...Objective: Survival and treatment of patients with microinvasive breast cancer(MIBC) remain controversial. In this paper, we evaluated whether adjuvant chemotherapy is necessary for patients with MIBC to identify risk factors influencing its prognosis and decide the indication for adjuvant chemotherapy.Methods: In this retrospective study, 108 patients with MIBC were recruited according to seventh edition of the staging manual of the American Joint Committee on Cancer(AJCC). The subjects were divided into chemotherapy and non-chemotherapy groups.We compared the 5-year disease-free survival(DFS) and overall survival(OS) rates between groups. Furthermore, we analyzed the factors related to prognosis for patients with MIBC using univariate and multivariate analyses. We also evaluated the impact of adjuvant chemotherapy on the prognostic factors by subgroup analysis after median follow-up time of 33 months(13-104months).Results: The 5-year DFS and OS rates for the chemotherapy group were 93.7% and 97.5%, whereas those for the nonchemotherapy group were 89.7% and 100%. Results indicate that 5-year DFS was superior, but OS was inferior, in the former group compared with the latter group. However, no statistical significance was observed in the 5-year DFS(P=0.223) or OS(P=0.530) rate of the two groups. Most relevant poor-prognostic factors were Ki-67 overexpression and negative hormonal receptors. Cumulative survival was 98.2% vs. 86.5% between low Ki-67(≤20%) and high Ki-67(>20%). The hazard ratio of patients with high Ki-67 was 16.585 [95% confidence interval(CI), 1.969-139.724; P=0.010]. Meanwhile, ER(-)/PR(-) patients with MIBC had cumulative survival of 79.3% compared with 97.5% for ER(+) or PR(+) patients with MIBC. The hazard ratio for ER(-)/PR(-) patients with MIBC was 19.149(95% CI, 3.702-99.057; P<0.001). Subgroup analysis showed that chemotherapy could improve the outcomes of ER(-)/PR(-) patients(P=0.014), but not those who overexpress Ki-67(P=0.105).Conclusions: Patients with MIBC who overexpress Ki-67 and with negative hormonal receptors have relatively substantial risk of relapse within the first five years after surgery. However, adjuvant chemotherapy can only improve the outcomes of ER(-)/PR(-)patients, but not those who overexpress Ki-67. Further studies with prolonged follow-up of large cohorts are recommended to assess the prognostic significance and treatment of this lesion.展开更多
文摘目的:分析乳腺旋切微创术治疗多发性乳腺纤维瘤的疗效及美容效果。方法:选取2019年3月~2020年9月收治的104例多发性乳腺纤维瘤患者,随机分为微创组和传统组各52例。微创组接受乳腺旋切微创术治疗,传统组接受传统乳腺纤维瘤切除术治疗。对比两组手术相关指标(术中出血量、手术时间、切口直径、切口愈合时间)、疼痛评分、并发症情况和美容效果评分。结果:微创组术中出血量低于传统组,手术时间、切口直径、切口愈合时间短于传统组(P<0.05);微创组术后局部血肿和出血发生率低于传统组(P<0.05),两组术后局部感染发生率对比无统计学差异(P>0.05);微创组术后6 h、12 h、24 h VAS评分均低于传统组(P<0.05);随访1个月,微创组美容效果评分(乳头乳晕感觉、乳房形状、乳房切口瘢痕、色素沉着)均高于传统组(P<0.05)。结论:乳腺旋切微创术可明显缩短乳腺纤维瘤患者手术时间、切口直径和切合愈合时间,减少术中出血量,减轻术后疼痛,提高术后乳房美容效果,降低术后并发症发生风险。
文摘Objective: Survival and treatment of patients with microinvasive breast cancer(MIBC) remain controversial. In this paper, we evaluated whether adjuvant chemotherapy is necessary for patients with MIBC to identify risk factors influencing its prognosis and decide the indication for adjuvant chemotherapy.Methods: In this retrospective study, 108 patients with MIBC were recruited according to seventh edition of the staging manual of the American Joint Committee on Cancer(AJCC). The subjects were divided into chemotherapy and non-chemotherapy groups.We compared the 5-year disease-free survival(DFS) and overall survival(OS) rates between groups. Furthermore, we analyzed the factors related to prognosis for patients with MIBC using univariate and multivariate analyses. We also evaluated the impact of adjuvant chemotherapy on the prognostic factors by subgroup analysis after median follow-up time of 33 months(13-104months).Results: The 5-year DFS and OS rates for the chemotherapy group were 93.7% and 97.5%, whereas those for the nonchemotherapy group were 89.7% and 100%. Results indicate that 5-year DFS was superior, but OS was inferior, in the former group compared with the latter group. However, no statistical significance was observed in the 5-year DFS(P=0.223) or OS(P=0.530) rate of the two groups. Most relevant poor-prognostic factors were Ki-67 overexpression and negative hormonal receptors. Cumulative survival was 98.2% vs. 86.5% between low Ki-67(≤20%) and high Ki-67(>20%). The hazard ratio of patients with high Ki-67 was 16.585 [95% confidence interval(CI), 1.969-139.724; P=0.010]. Meanwhile, ER(-)/PR(-) patients with MIBC had cumulative survival of 79.3% compared with 97.5% for ER(+) or PR(+) patients with MIBC. The hazard ratio for ER(-)/PR(-) patients with MIBC was 19.149(95% CI, 3.702-99.057; P<0.001). Subgroup analysis showed that chemotherapy could improve the outcomes of ER(-)/PR(-) patients(P=0.014), but not those who overexpress Ki-67(P=0.105).Conclusions: Patients with MIBC who overexpress Ki-67 and with negative hormonal receptors have relatively substantial risk of relapse within the first five years after surgery. However, adjuvant chemotherapy can only improve the outcomes of ER(-)/PR(-)patients, but not those who overexpress Ki-67. Further studies with prolonged follow-up of large cohorts are recommended to assess the prognostic significance and treatment of this lesion.
