Clinical Study On The Efficacy And Safety Of Breast-conserving Surgery Combined With Sentinel Lymph Node Biopsy

Objective:The aim of this study was to investigate the difference in efficacy and safety of BCS(breast-conserving surgery,BCS)combined with SLNB(SLNB)and MRM(modified radical mastectomy,MRM)in the treatment of early breast cancer in this region and to analyze the advantages and disadvantages.To increase the awareness of patients on breast protection,provide the basis for clinicians to choose breast protection.Then improve the breast protection rate in the region,and provide first-line clinical data for the revision of surgical treatment strategies for early breast cancer in China.Methods:A total of 211 patients with primary early breast cancer who met the criteria for breast-conserving surgery and were admitted to the Department of Breast Surgery,Affiliated Hospital of Chengde Medical College from October 2013 to December 2020 were selected.A total of 106 patients treated with BCS+SLNB were observed;the control group consisted of 105 patients who refused BCS and required MRM.The two groups of patients were compared:(1)operation time,intraoperative blood loss,postoperative drainage tube removal time and postoperative hospital stay;(2)the occurrence of postoperative mild flap necrosis,subcutaneous exudate,moderate/severe lymphedema;(3)postoperative shoulder joint activity;(4)the degree of satisfaction with the cosmetic effect of surgery and the impact of surgery on their mental health;(5)the recurrence rate,metastasis rate,survival and death at 1,3 and 5 years after surgery.Results:The comparison between the two groups showed that:(1)Compared with the control group,the operation time,intraoperative blood loss,postoperative drainage tube removal time and total hospital stay in the observation group were reduced,and the differences had statistical significance(P<0.05);(2)Compared with the control group,the postoperative subcutaneous exudate and upper limb moderate/severe lymphedema in the observation group were significantly reduced,and the differences had statistical significance(P<0.05);the postoperative flap necrosis in the two groups had no statistical significance(P>0.05);(3)Compared with the control group,the postoperative shoulder joint activity in the observation group was better,and the differences had statistical significance(P<0.05);(4)Compared with the control group,the patients in the observation group had higher satisfaction rate of surgical cosmetic effect and lower incidence rate of postoperative psychological disorders,and the differences had statistical significance(P<0.05);(5)Compared with the two groups,the 1-year,3-year and 5-year disease recurrence rate,metastasis rate and survival had no statistical significance(P<0.05).Conclusion:1 For patients with early breast cancer,the choice of BCS+SLNB and MRM survival is equivalent,but did not increase its long-term recurrence and metastasis rate,confirming that it is safe and effective.2 Compared with MRM,BCS+SLNB had lower incidence of postoperative subcutaneous hydrops,moderate/severe lymphedema in upper limbs,and less effect on shoulder joint activity.3 Compared with MRM,BCS+SLNB has better postoperative cosmetic results,can better protect the psychological status of patients,maintain patient dignity,and improve the quality of life of patients.4 Compared with MRM,BCS+SLNB has shorter operation time,earlier extubation time,less intraoperative blood loss,and faster postoperative recovery and discharge.5 This study confirms many advantages of BCS+SLNB compared with MRM.In order to increase the patients’ awareness of breast protection and provide the basis for clinicians to select breast protection,and then improve the breast protection rate in this region.