早期三阴性乳腺癌保乳手术治疗的临床效果  

Clinical effect of breast-conserving surgery in early triple negative breast cancer

作　　者：曹志宇[1] 张庆军 吴有军[1] 刘瑞军[1] 何建苗[1] Cao Zhi-Yu;Zhang Qing-Jun;Wu You-Jun;Liu Rui-Jun;He Jian-Miao(Department of General Surgery,the Eighth Medical Center of PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心普通外科,北京100091

出　　处：《解放军医学杂志》2020年第9期986-989,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的分析早期三阴性乳腺癌(TNBC)患者采取保乳手术治疗的临床效果。方法回顾性分析2010年1月-2015年1月解放军总医院第八医学中心普通外科收治的56例早期(Ⅰ期+Ⅱ期)TNBC患者的临床资料。其中采用保乳手术治疗27例(保乳手术组),同期因自身意愿、经济因素等原因选择改良根治术29例(改良根治术组)。术后均进行辅助放化疗,5年随访,比较两组患者术后局部复发率、远处转移率、5年生存率、手术时间、术中出血量、住院时间、术后并发症、生活质量情况等。结果两组患者术后局部复发率、远处转移率、5年生存率、手术时间比较,差异无统计学意义(P>0.05);保乳手术组患者术中出血量明显少于改良根治术组,术后并发症发生率明显低于改良根治术组,住院时间明显短于改良根治术组,症状自评量表SCL90评分总分、总症状指数、阳性项目数、阳性项目均分明显低于改良根治术组(P<0.05)。结论早期TNBC患者采取保乳手术治疗安全有效,与改良根治术相比,保乳手术可明显缩短术后恢复时间,减少手术并发症,提高患者术后生活质量。Objective To investigate the effect of breast conserving surgery in early triple negative breast cancer(TNBC).Methods Data of 56 early(stageⅠandⅡ)TNBC patients in the Eighth Medical Center of PLA General Hospital from January 2010 to January 2015 were analyzed retrospectively,and they were divided into breast-conserving surgery group(n=27)and modified radical surgery group(n=29)who chose the modified radical surgery due to their own willingness and economic factors.Patients in both groups received adjuvant chemoradiotherapy and were followed up for 5 years.Postoperative local recurrence rate,distal metastasis rate,5-year survival rate,operative time,amount of bleeding,hospital stays,postoperative complications,Symptom Check List 90(SCL90)were compared between the two groups.Results There were no significant differences in local recurrence rate,distant metastasis rate,operative time and survival rate between the breast-conserving surgery group and the modified radical surgery group(P>0.05).The postoperative complications,amount of bleeding,hospital stays in the breast-conserving surgery group were significantly lower than those in the modified radical surgery group(P<0.05).The SCL90 total score,total symptom index,positive items,and average of positive items of the patients who survived 5 years after the operation were also significantly lower than those of the modified radical surgery group(P<0.05).Conclusion Breast-conserving surgery for early TNBC patients is safe and effective.There was no significant difference in operation time between breast-conserving surgery and modified radical surgery,but breast-conserving surgery can shorten the postoperative recovery time,reduce surgical complications,and improve the postoperative quality of life.

关 键 词：早期 三阴性乳腺癌 保乳手术 

分 类 号：R737.9[医药卫生—肿瘤]