The Research In Endoscopic Axillary Lymph Node Dissection Of Breast Conservative Surgery

Objective:To study the short-term effect and superiority of breast conserving assisted by mastoscopy and axillary lymph node dissection (ALND), compared to the traditional breast-conserving surgery on patients with early breast cancer so as to offers more choices for breast cancer surgery.Methods:Early breast cancer were tested from 2007 May to 2009 May in Dalian Central Hospital,60 cases of whom were included in the study with single breast lumps of a diameter≤3 cm, and a distance≥2 cm without nipple inversion nor nipple discharge. The patients were divided into two groups according to the way of surgical treatment. One is the mastoscopy assisted group (group A) and the other is the traditional group (group B). The mastoscopy assisted group (group A) underwent open conserving surgery removal of lesions and axillary lymph node dissection assisted by mastoscopy. The traditional breast conserving group (group B) underwent conserving resection with axillary lymph node dissection. The two groups both accepted postoperative radiotherapy of breast and lesions, and the patients all received adjuvant chemotherapy and endocrine therapy according to the pathology and their conditions. The effects of axillary lymph node dissection assisted by mastoscopy was assessed in contrast with the operation time, the number of harvested lymph nodes, the condition of Lymph node damage and metastasis, postoperative drainage, postoperative extubation time and postoperative follow-up results of the other group.Results:1.30 patients of the endoscopic group underwent operation successfully with the help of mastoscopy, their axillary incisions are small and hidden, without upper limb swelling and other complications, in contrast, there are 2 cases of upper limb swelling in the 30 patients of the traditional group. All patient were followed up after operation for a longest follow-up period of 24 months and a median follow-up period of 17 months without metastasis and recurrence and death. 2. Viewing from a statistical perspective, although the operation time of breast conserving assisted by mastoscopy is longer than the traditional conserving surgery, the postoperative drainage, extubation time, the length of axillary incision and other indicators of breast conserving assisted are significantly better. There was no significant difference between the number of harvested lymph nodes and metastasis rate in the two groups (P<0.05).Conclusions:1. Without lowering the survival rate and affecting the recurrence, breast conserving assisted by mastoscopy is simple, minimally invasive and clinical feasible with less complication. In addition, it manifests the functional and cosmetic effects. So it may be a reasonable method to cure breast cancer of phaseⅠandⅡ.2. There is no significant difference between the recurrence rate of breast conserving assisted by mastoscopy and the traditional surgery according to the current result which tracks. It needs long-term follow-up and further study to assess their curative effect.