The Comparative Analysis Of Breast-conserving Therapy And Modified Radical Mastectomy

Research objective:To investigate the therapeutic efficacy of breast- conserving therapy (BCT) for breast cancer in stageⅠandⅡby comparing with modified radical mastectomy (MRM).Clinical materials and methods:BCT was carried out in 32 patients with breast cancer in this hospital from January 2003 to October 2005. There were 20 patients in stageⅠ, 12 patients in stageⅡ. The surgical treatment was local wide lumpectomy or quadrantectomy, combined with axillary lymph node dissection. Routine adjuvant irradiation, chemotherapy and hormone therapy were given postoperatively. During the same period, 92 patients in stageⅠand II (61 patients in stage I, 31 patients in stageⅡ) were treated by modified radical mastectomy.Postoperative routine adjuvant therapy was also given.Results:Pathological examinations: In BCT group, the average of axillary lymph node was 8.9 and 7 case was positive (21.9%).In MRM group, pathological examinations of breast specimens found no positive margins. The average of axillary lymph node was 10.1 and 20 case was positive (21.7%).Subsistence: In BCT group, follow-up observations after median of 19 months (8～36 months) revealed that local recurrence and distant metastasis did not occur and all patients have been living. In MRM group, the local recurrence rate was zero (0/107). Distant metastasis occurred in 2 patients (2.2%) and 1 of them died. Sites of metastasis included the left supra- clavicular lymph node and lung. The duration from surgery to distant metastasis was 18～30 month.Evaluation of cosmetic: Evaluation of cosmetic in 15 patients who had received BCT for at least 6sh months showed that good outcomes we achieved in 75.0% of the patients (24/32), fair outcomes, in 21.9% of the patients (7/32).Therapeutic efficacy: The difference of the short-term therapeutic efficacy in two group was not statistically significant, P>0.05.Conclusion:For patients with breast carcinoma in stageⅠandⅡ, the effect of BCT is satisfactory as that of MRM. Systemic combination treatment, such as standard excision, postoperative irradiation, chemotherapy and hormone therapy, is crucial to BCT. Most patients receiving BCT have good cosmetic results. For clinical stageⅠandⅡbreast carcinoma, BCT is recommended.