中央区乳腺癌保乳治疗与乳房切除的结局分析  

Outcome of breast-conserving surgery and mastectomy for centrally located breast cancer

作　　者：叶谋瑶 何中南 凌雪君 杨剑波 YE Mou-yao;HE Zhong-nan;LING Xue-jun;YANG Jian-bo(Department of Thyroid and Breast Surgery,Hezhou people’s Hospital,Hezhou 542800,China)

机构地区：[1]贺州市人民医院甲乳外科,广西贺州542800

出　　处：《广东医科大学学报》2023年第4期436-439,共4页Journal of Guangdong Medical University

摘　　要：目的比较中央区乳腺癌(CLBC)保乳治疗(BCS)与乳房切除术的结局。方法回顾性分析195例CLBC患者的临床资料,评价保乳手术的乳房美容效果,采用Kolcaba舒适状况量表(GCQ)评估患者整体舒适度,采用Kaplan-Meier法比较保乳患者与乳房切除患者的无复发生存期。结果保乳组患者术后整体舒适度优于乳房切除组患者(P<0.01)。保乳组出现切口裂开1例、局部脂肪液化3例、腋窝积液1例。乳房切除组出现腋窝积液3例、皮肤切缘瘀黑愈合迟缓5例、术后乳头表皮红肿脱皮3例。两组患者均未见皮瓣及乳头、乳晕感染坏死。随访期间,保乳组局部复发2例,区域淋巴结复发转移2例,远处转移4例;乳房切除组局部胸壁复发6例,区域淋巴结复发转移5例,远处转移14例。两组复发、远处转移及无复发生存期比较差异均无统计学意义(P>0.05)。结论BCS是CLBC患者可选择的治疗方案,保留乳房外形的同时具有较好的安全性。Objective To compare the outcomes of breast-conserving surgery(BCS)and mastectomy for centrally located breast cancer(CLBC).Methods The clinical data of 195 cases of centrally located breast cancer were analyzed retrospectively to evaluate the cosmetic effect of BCS.Kolcaba’s General Comfort Questionnaire(GCQ)was used to evaluate the overall comfort of the patients.Kaplan-Meier method was used to compare the recurrence-free survival between the Breast-Conserving Group and the Mastectomy Group.Results The overall postoperative comfort in the Breast-Conserving Group was superior to that in the Mastectomy Group(P<0.01).In the breast-conserving group,there was 1 case of incision rupture,3 cases of partial fat liquefaction,and 1 case of axillary effusion.In the Mastectomy Group,there were 3 cases of axillary effusion,5 cases of delayed healing of skin incision margins,and 3 cases of postoperative swelling and peeling of nipple epidermis.No infection and necrosis of flaps,nipples,and areola were found in both groups.During the follow-up period,there were 2 cases of local recurrence,2 cases of regional lymph node recurrence and metastasis,and 4 cases of distant metastasis in the Breast-Conserving Group;there were 6 cases of local chest wall recurrence,5 cases of regional lymph node recurrence and metastasis,and 14 cases of distant metastasis in the Mastectomy Group.There were no statistical differences in recurrence,distant metastasis and recurrence-free survival between the two groups(P>0.05).Conclusion BCS is an optional therapeutic regimen for CLBC patients.It has good safety while preserving the shape of the breast.

关 键 词：中央区乳腺癌 保乳手术 乳房切除术 乳头乳晕复合体 美容效果 

分 类 号：R737.9[医药卫生—肿瘤]