Evaluation On The Safety Of Breast Cancer Surgery With Skin-sparing Overlying The Tumor

Background and Objective:Breast cancer is the disease of women in the world in cachexia and fatality rate,and has always been in the first place.On January 25,2016,The National Cancer Registry published Chinese cancer statistics in 2015 in CA Cancer J Clin magazine,the report shows that breast cancer account for 15%,and grows rapidly in the rate of 3% to 4% among Chinese women.The incidence of breast cancer in women that in developed coastal provinces and cities is regarded as significantly higher than that in remote towns and villages.Due to the development of the economy and the progress of science and technology,the demand for the appearance of the patients has been improved continuously,and the surgery of breast cancer is also under the premise of ensuring the curative effect to achieve cosmetic result.In this study,we analyzed and discussed the following topics:(1)The oncological safety of skin-sparing overlying the tumor mammectomy.(2).The feasibility of skinsparing overlying the tumor mammectomy.That is in order to provide a theoretical basis for the breast cancer surgery with the skin-sparing overlying the tumor.Data and Methods:All the datas are collected from Thyroid and Breast Surgery Department of dalian related hospital form February 2010 to December 2012 in dalian related hospital,including 243 cases of primary breast cancer,all the patients were women,and 118 cases underwent skin-sparing mammectomy for breast cancer,as the observation group;the remaining 125 patients underwent radical resection of conventional breast cancer modified as control group,which were all confirmed of primary breast cancer patients by pathology.According to pathological report of Pathologists,we record the datas of patients with skin infiltration affected,and the patients' clinical pathological datas,then according to the statistical results of skin involvement group and made R * C tables,we analysised X list datas by c2 test,P < 0.05 was regard as statistically significant differences.By the chi square test and Fisher exact probability method,the datas of the observation group was analysised,which are about patients with clinical data and tumor characteristics tumor,pathological features and skin involvement;Multivariate Logistic regression and ROC curve accounted for the key factors affecting the infiltration of skin involvement by evaluating the clinical features and tumor characteristics and pathology,According to the results of follow-up,the local recurrence rate of the observation group and the control group in 3 and 5 years were analyzed by the chi square test.all statistical test level is P<0.05,a two-sided test is effective.Results:Patients in the observation group with breast cancer in the observation group who underwent simplified radical mastectomy were included in this study.Skin infiltration was found in 6 patients,skin infiltration rate was 5.1%.According to the results of single factor analysis,there was no significant difference between the incidence of skin infiltration with the age,menstrual status,tumor location,tumor size,the distance from the tumor to the skin,the distance from the tumor to subcutaneous tissue,the distance from the tumor to the chest wall,axillary lymph node metastasis,hormone receptor expression,histologic classification(P > 0.05);The incidence of skin infiltration was significantly related to with the changes of the surface of the skin overlying on the tumor,histology stage(P < 0.05).Regarded the factors associated with skin infiltration as variables,we conducted multiariable Logistic regression analysis,and the analysis results suggest that the tumor surface changes in skin,"dimples" appearance,"orange peel like" appearance of invasive lobular carcinoma is an independent risk factor for skin infiltration involvement.The observation group and the control group in the distribution of age,pathological type,ER/PR,Her-2 and Ki67% have no significant difference,P>0.05;Skin infiltration rate was 5.1% in the observation group,the control group skin infiltration rate was 4.8%,and there was no significant difference in statistics,P > 0.05.The observation group of local recurrence rates in 3 years and in 5 years were 5.3%?7.1%,However,the control group of local recurrence rates in 3 years and in 5 years were 3.2%,4%,but in the observation group and the control group,the distribution between the local recurrence rate in 3 years and local recurrence rate in 5 years were not statistically significant,P > 0.05.Conclusion:1.The incidence of skin overlying the tumor of breast cancer infiltration rate is low,in this study,the incidence infiltration rate was 5.1%,the infiltrated skin associated with the changes in skin appearance,histology stage,and "dimples" appearance,the "orange peel" appearance and invasive lobular carcinoma is independent risk factor for skin infiltration.2.when the surface appearance overlying the tumor of breast cancer has changed,especially showed "dimples","orange peel " appearance and pathology of invasive lobular carcinoma patien-ts,presenting the skin overlying the tumor of breast cancer should be carefully discreet or even rejected.3.Compared with the conventional modified radical mastectomy,brsast cancer surgery with skin-sparing overlying the tumor is safe.The local recurrence rate in 3 years and in 5 years is5.3% and 7.1%.The local recurrence There was no significant change in local recurrence risk.