Clinical Observation of Breast Conserving Surgery and Modified Radical Mastectomy in the Treatment of Early Breast Cancer

Clinical Observation of Breast Conserving Surgery and Modified Radical Mastectomy in the Treatment of Early Breast Cancer

SU,Lita

Affiliated Hospital of Xi'an Medical College,Xi’an Shanxi 710000,China

【Abstract】The purpose of the study was to compare the clinical efficacy of breast conserving surgery and modified radical mastectomy in the treatment of early breast cancer.Firstly,the clinical data of 74 patients with early breast cancer treated in our hospital from June 2015 to June 2016 were retrospectively analyzed.Among them,37 patients treated with breast-conserving surgery were set as the study group,and 37 patients treated with modified radical surgery were set as the control group,and the therapeutic effects of the two groups were compared.The results showed that compared with the control group,the incision length,intraoperative blood loss,operation time and hospital stay time were better in the study group,and the excellent and good rate of postoperative breast beauty was higher,with statistically significant differences(P<0.05).There were no statistically significant differences in distant metastasis rate,local recurrence rate,axillary lymph node recurrence rate and fatality rate between the two groups(P>0.05).Therefore,breast-conserving surgery and modified radical surgery have better efficacy in the treatment of early breast cancer,but breast-conserving surgery has more advantages,such as smaller incision,less intraoperative blood loss,shorter operative time and hospital stay,and better postoperative aesthetic effect,which can be used as the first choice for early breast cancer.

【Keywords】Early breast cancer;Maintain breast augmentation;Improved radical resection;Clinical curative effect

1.Introduction

Breast cancer is a kind of malignant tumor with a high incidence,which has a great negative impact on the qual-ity of life and physical and mental health of patients[1].The incidence of breast cancer is increasing year by year,and the incidence of breast cancer shows a younger trend.The treatment of breast cancer has attracted wide atten-tion from the whole society[2].In clinical practice,most patients with stage I and II breast cancer are treated by surgical methods.Traditional modified radical resection has a better effect,with some reservation for pectoralis major and pectoralis minor.But its excision scope is large,after the entire mastectomy would cause bilateral breast asymmetry,affect the appearance,will bring greater psy-chological trauma to the patients[3].The most commonly used surgical method for the treatment of early breast cancer is modified radical mastectomy,which has a good surgical effect but has a great impact on the patient's physical appearance[4].Along with the advance of medical technology,a major breakthrough in treatment of early breast cancer,a new type of breast augmentation bao has obtained the remarkable effect in clinical applications,the surgical curative effect not only,and easy operation,less trauma to patients,postoperative recovery faster,can meet the requirements of patients on breast beauty,highly praised by patients[5].The study compared the clinical efficacy of breast conserving surgery and modified radical mastectomy in the treatment of early breast cancer,and the report is as follows.

2.Materials and Methods

2.1 Subjects

In the study,74 cases of early-stage breast cancer pa-tients treated in our hospital from June 2015 to June 2016 were selected and pided into study group and control group with 37 cases each according to different treatment methods.The patients in the study group were aged from 30 to 63 years,with an average age of(44.2±3.9)years.There were 27 cases of TNM stage I and 10 cases of IIa stage,including 14 cases of left breast cancer,17 cases of right breast cancer and 6 cases of bilateral breast cancer.Patients in the control group were 32 to 61 years old,with an average age of(43.0±3.6)years.There were 25 cases of TNM stage I and 12 cases of IIa stage.Among them,there were 13 cases of left breast cancer,16 cases of right breast cancer and 8 cases of bilateral breast cancer.There was no statistically significant difference in clinical data between the two groups(P>0.05),which could be com-pared.

2.2 Methods

The patients in the study group were treated with breast-conserving therapy.The appropriate incision was selected according to the tumor location of the patient.The shape of the incision was radial or curved along the areola,and the glandular tissue 3 cm away from the tumor was completely removed.Breast lobectomy or lobectomy was performed according to the actual situation of the breast.Frozen section examination was performed at the cutting edge.If the examination results were positive,the resection scope should be expanded until the examination results turned negative.Finally,subaxillary lymphadenec-tomy was performed from the lateral part of the axillary lymph node to the latissimus dorsi muscle and up to the axillary vein.The negative pressure drainage tube was then used for drainage,after which the incision was su-tured and the compression dressing was performed.

Patients in the control group were treated with modi-fied radical resection.Longitudinal or transverse spindle shaped incision was made 3cm away from the edge of the tumor,the skin was cut open,and then the skin flap was conducted for dissection of the subclavicular blood ves-sels.The lymph nodes of the dry vein fossa were dissected and rinsed.A drainage tube was placed in the armpit and chest wall for drainage.Finally,the incision was sutured and the pressure dressing was performed,and the drainage tube was removed after 3 d.

2.3 Observation Indicator

Incision length,intraoperative blood loss,operation time and hospital stay time were compared between the two groups.The results of postoperative breast beauty were compared between the two groups.The treatment effect of the 2 groups was compared.

Excellent.The appearance and symmetry of the breast were the same as that of the contralateral side,and the horizontal height difference between the two nipples was

≤2cm.

Good.Both breasts are symmetrical,slightly smaller than the contralateral shape,and the horizontal height of both nipples differed by 3 cm.

Poor.Bilateral breasts are asymmetric,with significant-ly reduced appearance and a horizontal height difference of>3cm between the two groups.

Excellent and good rate=(excellent+good)/total cases

×100%

2.4 Observation of Adverse Reactions

The occurrence of complications,including pain,skin redness and swelling,erosion of skin lesions,and infec-tion,was recorded,and the incidence of adverse reactions was calculated.

2.5 Statistical Tests

SPSS19.0 statistical software was used to process the data.Measurement data were expressed as,and compar-ison between groups was performed by t test.Count data were tested byχ2,and P<0.05 was considered statistically significant.

3.Results and Discussion

3.1 Comparison of Surgical Parameters and Length of Time between the Two Groups

As shown in Table 1,compared with the control group,the study group patients had shorter incision length,less intraoperative blood loss,shorter operation time and shorter hospital stay,and the differences were statistically significant(P<0.05).

Table 1.Comparison of surgical indicators and length of stay between the two groups()

3.2 Comparison of Postoperative Breast Beauty Effect between the Two Groups

As shown in Table 2,the excellent and good rate of postoperative breast beauty in the study group(97.3%)was higher than that in the control group(81.1%),the dif-ference was statistically significant(P<0.05).

Table 2.Comparison of postoperative breast beauty effect between the two groups

3.3 Comparison of Effect of Treatment between the Two Groups

As shown in Table 3,there were no statistically signifi-cant differences in distant metastasis rate,local recurrence rate,axillary lymph node recurrence rate and fatality rate between the two groups(P>0.05).

Table 3.Comparison of treatment effect between the two groups

4.Discussion

In the study,it was found that both breast-conserving surgery and modified radical surgery had ideal efficacy in the treatment of early breast cancer,and there were no statistically significant differences in the distant metastasis rate,local recurrence rate,axillary lymph node recurrence rate and fatality rate between the two groups(P>0.05).However,compared with the control group,the patients treated with breast-conserving surgery had smaller surgi-cal incisions,less intraoperative blood loss,shorter oper-ative time and hospital stay,and higher rates of excellent and good breast beauty(P<0.05),which were similar to the results of Zheng et al[6].

5.Conclusion

In conclusion,the clinical efficacy of breast conserving surgery is similar to that of modified radical surgery in the treatment of early breast cancer,but breast conserving surgery has more advantages and better meets the aesthet-ic needs of patients.Breast surgery trauma is small,post-operative recovery is fast,it is recommended to promote clinical application.

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