保乳手术与改良根治术治疗Ⅰ-Ⅱ期乳腺癌患者的疗效及生存状况比较研究

目的:比较分析乳腺癌保乳手术和根治术的临床疗效及患者生存状况。方法:回顾性分析2012年6月至2015年6月在我院乳腺外科行手术治疗的乳腺癌患者92例的临床资料,其中行保乳手术患者24例(保乳组),行根治手术患者68例(根治组),两组患者术后均采用个性化综合治疗巩固疗效,对比观察两组疗效及预后状况;通过乳腺癌生命质量测定量表(FACT-B)检测对比两组患者术后1、2年的生存质量;并对比两组患者术后乳房美容效果。结果:保乳组患者手术时间、术中出血量、引流量以及引流时间均明显较根治组少,差异有统计学意义(P0.05),而淋巴结清扫数则无明显差异(P0.05);两组患者上肢水肿发生率无明显差异(P0.05),而保乳组切缘皮瓣缺血发生率低于根治组(P0.05);两组患者术后2年生存率、复发率以及远处转移率无统计学差异(P0.05)。保乳组患者术后1、2年生理状况、情感状况、社会状况、功能状况、其他因素及生活质量综合评分均显著高于根治组,差异有统计学意义(P0.05);保乳组术后乳房美容效果的优良率显著高于根治组,差异有统计学意义(P0.05)。结论:相比于根治术,保乳手术不仅具有创伤小、术后恢复快的优势,患者预后状况与根治术相当,同时可更好的改善患者生存质量,术后乳房美容效果较好,临床应用价值更高。

Comparative Study the Efficacy and Survival Status of Breast Conserving Surgery and Modified Radical Mastectomy in the Treatment of Stage I-II Breast Cancer

ABSTRACT Objective: To compare the clinical efficacy and survival status of patients with breast conserving surgery and radical mastectomy. Methods: The clinical data of 92 cases of patients with breast cancer who were treated with breast surgery from June 2012 to June 2015 in our hospital were analyzed retrospectively. Among them, 24 patients were underwent breast conserving surgery (breast con- serving group), and 68 patients were underwent radical surgery (radical group). The efficacy and prognosis were compared between the two groups. The quality of life was compared between the two groups after 1 and 2 years by the breast cancer quality of life scale (FACT-B), and compared the cosmetic results of two groups after mastectomy. Results: The operation time, intraoperative blood loss, drainage volume and drainage time in the breast conserving group were significantly less than those in the radical group, the difference was statistically significant (P<0.05), but there was no obvious difference of lymph nodes (P>0.05). There was no significant difference in the incidence of upper limb edema between the two groups (P>0.05), while the incidence of flap ischemia in the breast conserving group was significantly lower than that in the radical group (P<0.05). There was no significant difference in postoperative 2 year survival rate, recurrence rate and distant metastasis rate between the two groups (P>0.05). The nutritional status, emotional status, social status, func- tional status, other factors and quality of life scores in the breast conserving group at 1 and 2 years after the operation were significantly higher than those in the radical group, the differences were statistically significant (P<0.05). The excellent and good rate of breast cos- metic effect in the breast conserving group was significantly higher than that in the radical group, the difference was statistically signifi- cant (P<0.05). Conclusion: Compared with the radical mastectomy, breast conserving surgery has the advantages of less trauma and quicker recovery, and the prognosis is similar to radical resection. At the same time, it can better improve the quality of life of patients, the cosmetic effect of breast surgery is better, and the clinical application value is higher.