Comparative Study Of Oncoplastic Breast Conserving Surgery And Regular Breast Conserving Surgery In The Treatment Of Early Breast Cancer

Objective:To compare and analyze the clinical efficacy and safety of oncoplastic breast conserving surgery and regular breast conserving surgery in patients with early breast cancer.Method:136 early breast cancer patients diagnosed and treated from January 2015 to November2019 by the Breast Center of the Cancer Hospital of Shantou University Medical College were selected as the subjects of this study.The surgeon based on the size of the patient’s breast,the size of the tumor,the position of the tumor,the volume of the breast to be removed for the operation,etc.choose the operation method that suits the patient.According to the different operation methods,they are divided into 2 groups,65 cases in the oncoplastic breast conserving surgery group and 71 cases in the regular breast conserving surgery group.The surgical blood loss,operation time,length of hospitalization,tumor diameter,surgical specimen volume,postoperative complications,disease-free survival,overall survival,postoperative patient’s subjective evaluation of the cosmetic effect of breast shape and the doctor’s objective evaluation of the cosmetic effect of breast shape were compared between the two groups of patients.Result:(1)Among the 136 patients who underwent breast-conserving surgery,65 patients underwent oncoplastic breast conserving surgery,accounting for 47.79%.Among them,2patients underwent batwing shape oncoplasty,and 4 patients underwent inverted-T mammaplasty,11 patients underwent L mammaplasty,14 patients underwent j mammaplasty,6 patients underwent tennis racket mammaplasty,26 patients underwent rotary flap technique.2 patients underwent purse-string suture.71 patients underwent regular breast conserving surgery,accounting for 52.21%,all of which were underwent with enlarged local tumor resection.(2)The surgical blood loss of the oncoplastic breast conserving surgery group was more than that of the regular breast conserving surgery surgery group(24.31±14.84 ml vs17.89±9.66 ml,P=0.004).The operation time of the oncoplastic breast conserving surgery group was longer than that of the regular breast conserving surgery group(111.92±21.467 min vs93.94±25.37 min,P=0.000).The length of hospitalization in the oncoplastic breast conserving surgery group was longer than that in the regular breast conserving surgery group(17.75±4.83 d vs 16.15±4.52 d,P=0.049).(3)The resected tumor diameter in the oncoplastic breast conserving surgery group was longer than that in the regular breast conserving surgery group(2.26±1.03 cm vs 1.75±0.67 cm,P=0.001).The volume of surgical specimens resected in the oncoplastic breast conserving surgery group was larger than that in the regular breast conserving surgery group(108.53±68.94cm3 vs 69.52±46.3cm3,P=0.000).(4)One case of postoperative hematoma occurred both in the poncoplastic breast conserving surgery group and the regular breast conserving surgery group.The incidence was 1.5% vs 1.4%,and the difference was not statistically significant(P=0.950).(5)In the regular breast conserving surgery group,the follow-up time was 15 months to 72 months,and the median follow-up time was 44 months.There were 5 patients with local recurrence or distant metastasis,4 people died,one of them died of cerebral hemorrhage,and the other three died of tumor recurrence and metastasis.The DFS of the patients in the regular breast conserving surgery group was 92.3%,and the OS was93.8%.The follow-up time of the oncoplastic breast conserving surgery group was 14 months to 65 months.The median follow-up time was 30.5 months.There were no cases of recurrence and metastasis.One person died.The cause of death was severe pneumonia.The DFS of the patient in the oncoplastic breast conserving surgery group was 100%,and the OS was98.4%.There was no statistical.(6)In the comparison of the subjective satisfaction of patients’ breast after surgery,the satisfaction rate of the oncoplastic breast conserving surgery group was higher than that of the regular breast conserving surgery group(93.7% vs 82.0%,P=0.043).In the comparison of doctors’ objective evaluation of the cosmetic effect of breast shape,the excellent and good rate of the oncoplastic breast conserving surgery group was higher than that of the regular breast conserving surgery group(90.0% vs 40.0%,P=0.015).Conclusion:1.Compared with regular breast conserving surgery,oncoplastic breast conserving surgery increases the patient’s operation time,blood loss and length of hospitalization.2.Oncoplastic breast conserving surgery can remove larger tumors and larger breast tissue volume.3.There is no significant difference in postoperative complications between oncoplastic breast conserving surgery and regular breast conserving surgery.4.Oncoplastic breast conserving surgery has a significant advantage in improving the effect of breast shape beauty.5.There is no significant difference in DFS and OS of patients after oncoplastic breast conserving surgery and regular breast conserving surgery.In general,oncoplastic breast conserving surgery can achieve clear clinical effects in improving cosmetic effect of patients breast shape,and it is worthy of clinical application.