早期乳腺癌保乳手术和改良根治术的临床疗效比较  

Breast-conserving surgery versus modified radical mastectomy for early breast cancer

作　　者：王泽 王建东[1] 陈晓燕[1] 王淼煜 刘丰源 WANG Ze;WANG Jiandong;CHEN Xiaoyan;WANG Miaoyu;LIU Fengyuan(Department of General Surgery Chinese PLA General Hospital,Beijing 100853,China;Department of Respiratory Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院普通外科,北京100853 [2]解放军总医院呼吸内科,北京100853

出　　处：《解放军医学院学报》2018年第11期955-958,共4页Academic Journal of Chinese PLA Medical School

基　　金：中国医药教育协会科研项目([2016]001)~~

摘　　要：目的探讨早期乳腺癌患者保乳术和改良根治术的临床疗效。方法回顾性分析2008年1月-2012年4月于我院确诊的早期乳腺癌患者,根据术式不同分为保乳手术组和改良根治术组,随访5年后两组患者的局部复发率、远处转移率、5年无病生存率(disease-free survival rate,DFS)和美容效果均无统计学差异。结果共纳入237例患者,平均年龄(42.03±9.65)岁。早期乳腺癌行保乳术(110例)和改良根治术(127例)。局部复发率保乳手术组为3.6%,改良根治术组为4.7%(χ2=0.173,P=0.755);远处转移率保乳手术组为5.4%,改良根治组为7.0%(χ2=0.265,P=0.607);DFS保乳手术组为93.6%,改良根治术组为92.1%(χ2=0.233,P=0.629)。保乳术后1年乳房美容效果优于改良根治组,差异有统计学意义(Z=-5.162,P <0.001)。结论保乳术临床疗效与改良根治术相当,但保乳术后乳房美容效果更好。Objective To investigate the clinical outcomes of breast conserving surgery and modified radical mastectomy for early breast cancer.Methods A retrospective analysis was conducted in patients with early stage breast cancer admitted to our hospital from January 2008 to April 2012.According to surgery techniques,patients were divided into breast conserving group and modified radical group.The local recurrence rate,distant metastasis rate,5-year disease-free survival rate (DFS)and cosmetic effect were compared between the two groups.Results There were 237 cases included in our study,with 110 cases in breast conserving group and 127 cases in modified radical group with average age of (42.03±9.65)years.There was no significant difference in local recurrence rate (3.6%vs 4.7%,P=0.755),distant metastasis rate (5.4% vs 7.0%,P=-0.607)and DFS (93.6% vs 92.1%,P=-0.629) between two groups.At 1 year after surgery,the cosmetic effect of breast conserving surgery group was significantly better than that of the modified radical group (Z=-5.162,P <0.001).Conclusion The surgical outcome of breast conserving surgery is similar to that of modified radical mastectomy,while the cosmetic effect of breast conserving surgery is better.

关 键 词：乳腺癌 保乳术 改良根治术 

分 类 号：R737.9[医药卫生—肿瘤]