乳腺癌保留乳房治疗后乳房美容效果的影响因素探讨

乳腺癌保留乳房治疗后乳房美容效果的影响因素探讨

傅建民;李先明;周颉;麦沛成;王恩礼;丘禹洪;罗建国;张文夏;郑爱秋

【期刊名称】《中华乳腺病杂志（电子版）》 【年(卷),期】2011(005)005

【摘要】目的 回顾性分析早期乳腺癌患者保留乳房治疗后影响美容效果的相关因素.方法 本院于1999年11月至2008年12月对162例临床0、Ⅰ、ⅡA期的乳腺癌患者实施保留乳房治疗,将乳头横向移位距离、乳头纵向移位距离、体表凹陷程度、乳房质地与弹性及皮肤色泽作为保留乳房治疗后的评判指标,于放射治疗后6个月综合评分判断美容效果.良好率差异比较采用卡方检验.结果 共实施保留乳房手术162例,占同期乳腺癌手术患者的12.8%(162/1266),术后病理分期为0期 32例,Ⅰ期83例,ⅡA期 47例.全部病例获随访,复发率为9.9%(16/162).保留乳房治疗后美容效果良好占61.1%(99/162),一般占35.2%(57/162),差占3.7%(6/162).采用双切口、保留皮肤、肿瘤广泛切除及适形放射治疗等技术者美容效果良好率显著高于单切口、切除皮肤、象限切除及非适形放射治疗组(P<0.01),而肿瘤分期和术后放射治疗开始时间是否早于12周对美容效果无影响 (P>0.05).结论 乳腺癌患者保留乳房治疗后美容效果良好,采用双切口、保留皮肤和肿瘤广泛切除等手术技巧以及适形放射治疗可提高保留乳房治疗的美容效果.%Objective To retrospectively analyze relevant factors influencing cosmetic results after breast-conserving therapy in early-stage breast cancer patients. Method From November 1999 to December 2008, 162 patients with stage 0, I and ⅡA breast cancer underwent breast-conserving surgery in our hospital. The distances of

nipple lateral and vertical displacement, the degree of concave body surface, the breast texture and resilience, and the skin color were taken as DostoDerative evaluation index for breast conserving therapy. The cosmetic assessment was done six months after radiotherapy. Fine and excellent rates were compared using chi-square test. Results All the 162 patients were treated with breast conserving surgery, occupying 12. 8% ( 162/1266 ) of the concurrent breast conserving surgeries. Postoperative pathological tumor staging showed stage 0 in 32 cases, stage I in 83 cases and stage ⅡA in 47 cases. All cases were followed up, demonstrating a relapse rate of 9.9%( 16/162 ). The cosmetic results showed that the good rate was 61.1% ( 99/162 ), moderate rate 35.2% ( 57/162 ) and poor rate 3. 7% ( 6/162 ). The good rate of cosmetics in patients using two-incision, conserving skin, extent resection of tumors and conformal radiation therapy was significantly higher than in one-incision, skin excision, quadrantectomy and un-modulated radiation therapy( P<0. 01 ). Tumor staging and whether the starting time for postoperative radiotherapy was earlier than 12 weeks did not affect the cosmetic results ( P>0. 05 ). Conclusion Early breast cancer patients treated with breast-conserving surgery can obtain good cosmetic results. Two-incision, conserving skin, extent resection of tumors and conformal radiation therapy in breast-conserving treatment can improve cosmetic results.

【总页数】8页(550-557)

【关键词】乳腺肿瘤;保留乳房治疗;美容效果;生活质量

【作者】傅建民;李先明;周颉;麦沛成;王恩礼;丘禹洪;罗建国;张文夏;郑爱秋 【作者单位】5180481,广东,深圳,南方医科大学附属深圳市妇幼保健院;518020,广东,深圳,深圳市人民医院;5180481,广东,深圳,南方医科大学附属深圳市妇幼保健院;518020,广东,深圳,深圳市人民医院;5180481,广东,深圳,南方医科大学附属深圳市妇幼保健院;5180481,广东,深圳,南方医科大学附属深圳市妇幼保健院;5180481,广东,深圳,南方医科大学附属深圳市妇幼保健院;5180481,广东,深圳,南方医科大学附属深圳市妇幼保健院;5180481,广东,深圳,南方医科大学附属深圳市妇幼保健院 【正文语种】中文 【中图分类】R737.9 【文献来源】

https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-breast-disease-electronic-edition_thesis/0201236734730.html 【相关文献】

1.影响早期乳腺癌保乳治疗后美容效果的若干因素 [C], 傅建民; 丘禹洪; 罗建国; 张文夏; 郑爱秋; 李先明; 麦沛成

2.两种乳腺癌根治术保留乳房后的局部复发率和美容效果比较 [J], 朱玉兰; 高海燕; 许凌云; 钱琦

3.保留乳房的乳腺癌切除术与改良根治术治疗绝经前乳腺癌患者的效果比较 [J], 罗兵; 陈意; 赵霞; 廖江秀