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不同手术方式对早期乳腺癌患者的术后恢复及并发症的影响
作者:曹欣华1  吕建鑫2  胡浩霖2  张亚男2 
单位:1. 东南大学 医学院, 江苏 南京 210009;
2. 东南大学附属中大医院 乳腺中心, 江苏 南京 210009
关键词:乳腺癌 前哨淋巴结活检 保乳手术 
分类号:R737.9
出版年·卷·期(页码):2018·37·第一期(45-49)
摘要:

目的:比较不同手术方式对早期乳腺癌患者围术期情况、术后并发症及术后恢复情况的影响。方法:对102例早期乳腺癌患者进行回顾性研究。42例行前哨淋巴结活检的病人设为研究组,60例行腋窝淋巴结清扫的病人设为对照组。比较2组患者的围术期情况、术后并发症及术后恢复情况。结果:2组患者的腋窝拔管时间、腋窝引流量、淋巴水肿主观评分有统计学差异,而手术时间、淋巴水肿客观测量、生存质量及美容效果无统计学差异。进一步的亚组分析显示保乳患者生存质量及美容效果优于全切患者。结论:采用保乳联合前哨淋巴结活检手术治疗早期乳腺癌,患者术后恢复情况良好,并发症少,值得推广。

Objective: To evaluate the influence of different types of surgical operations on the conditions of perioperative period, postoperative complication and postoperative recovery of patients with early-stage breast cancer. Methods: The 102 cases of patients were retrospectively studied. The 42 patients who accepted sentinel lymph node biopsy were chosen into the study group and the other 60 patients who accepted axillary lymph node dissection were chosen into the control group. The conditions of perioperative period, postoperative complication and postoperative recovery in the two groups were analyzed. Results: In comparisons of the two groups, there were significant differences in the removal of axillary drainage tube time, the total axillary drainage volume and the lymphedema subjective score. However, there were no significantly differences between the two groups in the operation time, the lymphedema subjective measurement, the quality of life and the cosmetic results. In the further analysis, the patients who received breast-conserving surgery had better quality of life and cosmetic result than the patients who received mastectomy. Conclusion: For patients with early-stage breast cancer, sentinel lymph node biopsy combined with breast-conserving surgery can have better effect.

参考文献:

[1] DESANTIS C E,FEDEWA S A,SAUER A G,et al.Breast cancer statistics,2015:convergence of incidence rates between black and white women[J].CA Cancer J Clin,2016,66(1):31-42.
[2] BRAY F,JEMAL A,WANQING C,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[3] 陈孝平.外科学[M].上册.2版.北京:人民卫生出版社,2010:402.
[4] FISHER B,ANDERSON S,BRYANT J,et al.Twenty-year follow-up of a randomized trial comparing total mastectomy,lumpectomy,and lumpectomy plus irradiation for the treatment of invasive breast cancer[J].N Engl J Med,2002,347(16):1233-1241.
[5] KRAG D N,ANDERSON S J,JULIAN T B,et al.Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer:overall survival findings from the NSABP B-32 randomised phase 3 trial[J].Lancet Oncol,2010,11(10):927-933.
[6] COSTER S,POOLE K,FALLOWFIELD L J.The validation of a quality of life scale to assess the impact of arm morbidity in breast cancer patients post-operatively[J].Breast Cancer Res Treat,2001,68(3):273-282.
[7] 万崇华,张冬梅,汤学良,等.乳腺癌患者生命质量测定量表FACT-B中文版介绍[J].中国肿瘤,2002,11(6):318-320.
[8] DEUTSCH M,LAND S,BEGOVIC M,et al.The Incidence of arm edema in women with breast cancer randomized on the national surgical adjuvant breast and bowel project study B-04 to radical mastectomy versus total mastectomy and radiotherapy versus total mastectomy alone[J].Int J Radiat Oncol Biol Phys,2008,70(4):1020-1024.
[9] 张亚男,钱宏美,尤承忠,等.保留乳头乳晕乳腺全切除术后Ⅰ期假体植入10例报告[J].中国实用外科杂志,2011,31(10):944-946.
[10] POLYAK K.Heterogeneity in breast cancer[J].J Clin Invest,2011,121(10):3786-3788.
[11] VERONESI U,CASCINELLI N,MARIANI L,et al.Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer[J].N Engl J Med,2002,347(16):1227-1232.
[12] LITIÈRE S,WERUTSKY G,FENTIMAN I S,et al.Breast conserving therapy versus mastectomy for stage I-Ⅱ breast cancer:20 year follow-up of the EORTC 10801 phase 3 randomised trial[J].Lancet Oncol,2012,13(4):412-419.
[13] BUCHHOLZ T A,SOMERFIELD M R,GRIGGS J J,et al.Margins for breast-conserving surgery with whole-breast irradiation in stage I and Ⅱ invasive breast cancer:American society of clinical oncology endorsement of the society of surgical oncology/American society for radiation oncology consensus guideline[J].J Clin Oncol,2014,32(14):1502-1506.
[14] LAZOVICH D,SOLOMON C C,THOMAS D B,et al.Breast conservation therapy in the United States following the 1990 National Institutes of Health consensus development conference on the treatment of patients with early stage invasive breast carcinoma[J].Cancer,1999,86(4):628-637.
[15] 张保宁,张斌,唐中华,等.中国乳腺癌手术治疗10年的发展与变迁[J].中华肿瘤杂志,2012,34(8):582-587.
[16] 中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2015版)[J].中国癌症杂志,2015,25(9):692-754.
[17] LYMAN G H,GIULIANO A E,SOMERFIELD M R,et al.American society of clinical oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer[J].J Clin Oncol,2005,23(30):7703-7720.
[18] GIULIANO A E,HUNT K K,BALLMAN K V,et al.Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis A randomized clinical trial[J].JAMA-J Am Med Assoc,2011,305(6):569-575.
[19] MANSEL R E,FALLOWFIELD L,KISSIN M,et al.Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer:the ALMANAC Trial[J].J Natl Cancer Inst,2006,98(9):599-609.
[20] SHAH C,VICINI F A.Breast cancer-related arm lymphedema:Incidence rates,diagnostic techniques,optimal management and risk reduction strategies[J].Int J Radiat Oncol Biol Phys,2011,81(4):907-914.

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