保乳手术与根治手术治疗早期乳腺癌疗效比较

目的 比较保乳手术与根治手术治疗早期乳腺癌的临床疗效.方法 76例早期乳腺癌患者,在知情同意下按患者及其家属意愿分成保乳组（BCT组,21例）和根治组（BR组,55例）,保乳组采用保乳手术治疗,根治组采用乳腺癌根治性手术,两组术后均按常规放化疗及内分泌治疗,观察比较两组临床治疗效果及并发症发生情况.随访1～6年,比较两组复发情况.结果 两组患者均治愈出院.保乳组发生皮下积液5例、切口脂肪液化2例、切口感染1例、患侧上肢水肿1例;根治组发生皮下积液8例、切口脂肪液化5例、切口感染2例、患侧上肢水肿3例,两组并发症发生率差异无统计学意义（P＞0.05）.保乳组生存质量评分均明显高于根治组（t=3.42、3.18、4.07、3.09、2.87、3.26,均P＜0.05）.所有病例均获定期随访,随访时间1～6年,保乳组局部复发率4.8%（1/21）,生存率95.2%（20/21）;根治组局部复发率3.6%（2/55）,生存率96.4%（53/55）,两组局部复发率及生存率差异均无统计学意义（均P＞0.05）.结论 保乳手术治疗早期乳腺癌安全可行,不增加复发率,且能够获得良好的生存质量.

Comparison of the effects of breast conservative therapy and radical mastectomy in treatment of patients with early stage breast cancer

Objective To compare the effects of breast conservative therapy and radical mastectomy in treatment of patients with early stage breast cancer.Methods 76 patients with early breast cancer,informed consent by themselves and their families were divided into breast conservative therapy group(BCT group,2 1 cases)and breast radical group(RT group,55 cases),and BCT group was conducted breast conserving surgery,and RT group Was given radical surgery of breast cancer.The two groups were all given conventional postoperative chemotherapy and endocrine therapy.Then the therapeutic effects and complications were observed and compared.Following up for 1 to 6 years,the recurrence was compared.Results All patients were cured.In BCT group,5 cases of subcutaneous fluid,2 cases offat liquefaction of incision,1 ease of wound infection,1 case of upper limb edema,and in RT group,8 cases of subcu-taneous fluid occurred,5 cases of wound fat liquefaction,2 cases of wound infection,3 cases of upper limb edema,and the difference of complication rate between the two groups had no significant difference(P＞0.05).The scores of quality life of BCT group were significantly higher than those of RT group(t=3.42,3.18,4.07,3.09,2.87,3.26,all P＜0.05).All patients were regularly followed up for 1 to 6 years,local recurrence rate and survival rate of BCT group Was 4.8%(1/21)and 95.2%(20/21),and those of RT group Was 3.6%(2/55)and 96.4%(53/55),and the difference of local recurrence rate and survival rate between the two groups had no statistical significance(all P＞0.05).Conclusion Breast conserving surgery for early breast cancer was safe and feasible without increasing the relapse rate,and could get a good quality of life.