关键词: 乳腺肿瘤, 外科手术, 生活质量, 手术后并发症

Abstract: Objective  To compare the clinical effects and safety of conventional modified radical mastectomy and modified radical mastectomy for reserved nipple areola in the treatment of breast cancer patients for Ⅰ-Ⅱa stage. Methods  One hundred breast cancer patients for Ⅰ-Ⅱa stage were chosen in the period from October 2011 to October 2013 in the central hospital of Jinzhou City and were randomly divided into two groups according to the random number table: the control group (50 patients) with conventional modified radical mastectomy and the observation group (50 patients) with modified radical mastectomy for reserved nipple areola. The operation time, the intraoperative blood loss, the number of lymph node dissection, the surgical aesthetic score, Functional Assessment of Cancer Therapy-Breast (FACT-B) score, the postoperative complication incidence, the 3 years follow-up of local recurrence rate, distant metastasis and survival rate in both groups were compared. Results  The operation time ［(163.36±39.13)min vs. (144.74±34.62)min］ and the intrao-perative blood loss ［(128.10±22.52)ml vs. (114.32±18.89)ml］ of the observation group were significantly higher than the control group, with significant differences (t=3.10, P＜0.001; t=2.87, P＜0.001). There was no significant difference in the number of lymph node dissection between the two groups ［(15.19±3.38) vs. (14.68±3.14), t=0.61, P=0.480］. The surgical aesthetic score in 6 months ［(9.61±0.38) vs. (7.28±0.84)］ and 12 months ［(9.32±0.46) vs. (7.05±0.76)］  after operation of the observation group were significantly higher than those of the control group (t=3.22, P＜0.001; t=3.51, P＜0.001). The social/family status score ［(22.86±5.21) vs. (19.23±4.38)］, functional status score ［(15.85±3.18) vs. (9.32±2.39)］, emotional status score  ［(18.85±3.98) vs. (15.32±2.39)］ and total score ［(95.73±14.16) vs. (82.26±10.35)］ of the observation group were significantly better than those of the control group (t=3.56, P＜0.001; t=3.19, P＜0.001; t=3.51, P＜0.001; t=3.24, P＜0.001). There was no significant difference in the postoperative complication incidence (24.00% vs. 16.00%) between the two groups (χ²=1.00, P=0.320). There were no significant differences in the local recurrence rate (0 vs. 2.00%) and the distant metastasis (4.00% vs. 6.00%) in 3 years followup between the two groups (P=1.000; χ²=0.00, P=1.000). The survival rates of the two groups were both 100.00%. Conclusion  Compared with conventional modified radical mastectomy, modified radical mastectomy for reserved nipple areola in the treatment of breast cancer patients for I-IIa stage can efficiently improve the surgical aesthetics, the overall quality of life and cannot increase the risk of longterm recurrence and metastasis.

Key words: Breast neoplasms, Surgical procedures, Quality of life, Postoperative complications