关键词: 早期乳腺癌, 前哨淋巴结活检, 保乳术, 改良根治术, 创伤后应激障碍

Abstract: Objective To explore the short-term and long-term efficacy of sentinel lymph node biopsy combined with breast conserving surgery and modified radical mastectomy in the treatment of stage Ⅰ-Ⅱ breast cancer and its impact on post-traumatic stress disorder(PTSD).Methods Between January 2016 and may 2019,220 breast cancer patients admitted to Qidong people's hospital were divided into two groups according to the treatment scheme,of which 135 patients in the radical cure group received modified radical surgery and 85 patients in the breast conservation group received sentinel lymph node biopsy combined with breast conservation surgery.The surgical indexes,breast aesthetic effect,PTSD level,serum tumor marker level,postoperative complications,3year overall survival rate and recurrence rate were compared between the two groups.Results The operation time,intraoperative bleeding volume,postoperative drainage volume and hospital stay in the breast conserving group were less than those in the radical group(P<0.05).The cosmetic effect of breast conserving group was better than that of radical mastectomy group(P<0.05).One week after operation,the levels of serum carcinoembryonic antigen(CEA) and carbohydrate antigen 153(CA153) in both groups were lower than those before operation(P<0.05).The scores of PTSD checklist version(PCL-C) in breast conserving group and radical therapy group were [(33.67±7.89) points and [(46.82±6.15) points],respectively,the PCL-C of the breastconserving group were lower than those of the radical treatment group in a week after operation,and both groups were higher than those before operation(P<0.05).There were no serious complications such as severe infection and flap necrosis in both groups.The incidence of postoperative complications in radical group was higher than that in breast conserving group(P<0.05).The 3-year survival rates of breast conserving group and radical operation group were 98.78% and 100.00% respectively,and the recurrence rates were 6.10% and 3.10% respectively,there was no significant difference in the 3-year survival rate and recurrence rate between the two groups(P>0.05).Conclusion The application of sentinel lymph node biopsy combined with breast conserving surgery in the treatment of stage Ⅰ-Ⅱ breast cancer patients is more helpful to shorten the operation time,hospital stay and other operation indicators,improve the postoperative breast aesthetic effect,reduce the incidence of postoperative complications and PTSD level,and the adjustment level of short-term tumor markers,long-term survival rate and recurrence rate after operation are equivalent to that of modified radical mastectomy.

Key words: early breast cancer, sentinel lymph node biopsy, breast conserving surgery, modified radical operation, post traumatic stress disorder