保乳手术和改良根治术治疗早期乳腺癌的临床对比研究

目的 探讨保乳手术和改良根治术治疗早期乳腺癌的临床效果。 方法 回顾性分析蚌埠医学院第一附属医院2012年1月-2016年6月期间的部分早期乳腺癌患者的临床资料,44例采用保乳手术的患者纳入保乳手术组,44例采用改良根治术的患者为改良根治组,对比分析保乳手术组和改良根治组的手术时间、术中出血量、住院时间、术后美容效果、复发率、转移率及生存率,以此来评估2种手术方式的疗效。 结果 ①保乳手术组患者的手术时间、住院时间明显短于改良根治组,术中出血量明显少于改良根治组。2组患者在手术时间、术中出血量和住院时间上差异均有统计学意义。②截至随访结束时,保乳手术组出现1例复发患者,1例转移患者,无死亡事件发生。改良根治组患者出现2例转移及1例死亡,无局部复发。2组患者复发率、转移率及生存率的比较无显著差异。③经判定,保乳手术组患者中有39例为优良,3例为一般,2例为差,保乳手术组患者的优良率为88.6%。改良根治组由于实施的是全乳房切除的手术,无美容效果,所以全部判定为差,保乳手术组术后美容效果明显优于改良根治组,差异有统计学意义。 结论 在早期乳腺癌治疗上,保乳手术与改良根治术相比具有手术时间短、术中出血少、住院时间短及术后恢复快的优点。同时,保乳手术与改良根治术在术后局部复发率、远处转移率及生存率上无明显差异,且术后美容效果好,值得临床推广。 

Clinical comparative study of breast-conserving surgery and modified radical mastectomy for early breast cancer

Objective To investigate the clinical effect of breast-conserving surgery and modified radical mastectomy in the treatment of early breast cancer. Methods The clinical data of 88 patients with early breast cancer from January, 2012 to June, 2016 in our hospital were analyzed retrospectively. Forty-four patients in the breast-conserving group received the breast-conserving surgery, while 44 patients in the modified radical group received the modified radical mastectomy. The operative time, intraoperative blood loss, hospitalization time, postoperative period cosmetic effect, recurrence rate, metastasis rate and survival rate were compared between the two groups in order to assess the efficacy of two surgical methods. Results ①The operation time and hospitalization time of the patients in the breast-conserving group were significantly shorter than those in the modified radical group, and the intraoperative blood loss was significantly less than that of the modified radical group. The difference between the two groups in the operation time, intraoperative blood loss and hospitalization time was statistically significant. ②At the end of follow-up, 1 case of recurrence occurred in the breast-conserving group, 1 case of metastasis, no death occurred. There were 2 cases of metastasis and 1 case of death in the modified radical group, and no local recurrence. There was no significant difference in recurrence rate, metastasis rate and survival rate between the two groups. ③ After the decision, 39 cases in the breast conserving group were excellent, 3 cases were general, 2 cases were poor. The excellent rate of breast-conserving patients was 88.6%. The cosmetic effect in the modified radical group was judged as poor because of the implementation of the whole mastectomy surgery, and the postoperative cosmetic effect of breast-conserving group was significantly better than that in the modified radical group, the difference was statistically significant. Conclusion In the treatment of early breast cancer, breast-conserving surgery is with the advantage of short operation time, less intraoperative bleeding, short hospital stay, good cosmetic effect and rapid postoperative recovery when compared with the modified radical surgery. There is no significant difference in the local recurrence rate, distant metastasis rate and survival rate between the two groups, which is worthy of clinical promotion.