保乳手术联合前哨淋巴结活检及腋窝保留对早期乳腺癌患者复发、转移、并发症及美容效果的影响。

Effect of breast-conserving surgery combined with sentinel lymph node biopsy and axillary preservation on the recurrence, metastasis, complications and cosmetic results of early breast cancer patients.

作者信息

Xiang Jing, Huang Shiqin, Tuo Youlin, Wang Yun

机构信息

Department of Outpatient, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science & Technology of China, Chengdu, China.

Department of Breast Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science & Technology of China, Chengdu, China.

出版信息

Gland Surg. 2020 Aug;9(4):1019-1025. doi: 10.21037/gs-20-584.

DOI:10.21037/gs-20-584

PMID:32953610

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7475360/

Abstract

BACKGROUND

As one of the main malignant tumors, breast cancer remains a worldwide public health issue. Here, we aimed to analyze the effects of breast-conserving surgery (BCS) combined with sentinel lymph node biopsy (SLNB) and axillary preservation on the recurrence, metastasis, complications, and cosmetic results of early breast cancer patients (BCPs).

METHODS

The clinical data of 143 BCPs admitted to our hospital from January 2017 to January 2019 were collected retrospectively, and all patients were female. Patients (76 cases) undergoing BCS combined with SLNB and axillary preservation treatment were set as the combined group, and 67 cases undergoing traditional modified radical surgery were set as the control group. After the perioperative conditions of patients in the two groups were compared, the patients were followed up for 14 months to record information on the quality of life, recurrence, metastasis, complications, and cosmetic results.

RESULTS

The operation time, intraoperative blood loss, and extubation time of the combined group were significantly less than the control group (P<0.05); the quality of life of patients in both groups improved after treatment, but the quality of life of patients in the combined group was significantly higher than that of the control group (P<0.05); both groups of patients were followed up for 14 months after treatment, and there were no deaths. The rates of local recurrence and distant metastasis were 2.98% and 5.97% in the control group and 5.26% and 6.57% in the combined group, respectively, showing no significant difference between the two groups (P>0.05); the incidence of postoperative complications was 14.92% in the control group, which was significantly higher than the incidence of 3.94% of the combined group (P<0.05); the proportion of postoperative cosmetic results with an excellent and good rating was 59.7% in the control group, which was significantly lower than the 93.42% reported in the combined group (P<0.05).

CONCLUSIONS

BCS combined with SLNB and axillary preservation provided good clinical and cosmetic results and can improve the quality of life of patients and reduce the rate of recurrence and metastasis.

摘要

背景

作为主要的恶性肿瘤之一，乳腺癌仍然是一个全球性的公共卫生问题。在此，我们旨在分析保乳手术（BCS）联合前哨淋巴结活检（SLNB）及腋窝保留对早期乳腺癌患者（BCP）复发、转移、并发症及美容效果的影响。

方法

回顾性收集2017年1月至2019年1月我院收治的143例BCP的临床资料，所有患者均为女性。将接受BCS联合SLNB及腋窝保留治疗的患者（76例）设为联合组，将接受传统改良根治术的67例患者设为对照组。比较两组患者围手术期情况后，对患者进行14个月的随访，记录生活质量、复发、转移、并发症及美容效果等信息。

结果

联合组的手术时间、术中出血量及拔管时间均显著少于对照组（P<0.05）；两组患者治疗后生活质量均有所改善，但联合组患者的生活质量显著高于对照组（P<0.05）；两组患者治疗后均随访14个月，均无死亡病例。对照组局部复发率和远处转移率分别为2.98%和5.97%，联合组分别为5.26%和6.57%，两组间差异无统计学意义（P>0.05）；对照组术后并发症发生率为14.92%，显著高于联合组的3.94%（P<0.05）；对照组术后美容效果优良率为59.7%，显著低于联合组的93.42%（P<0.05）。