Clinical Application Of Breast Conserving Surgery Combined With Intraoperative Radiotherapy In Early Breast Cancer

Objective:To analyze the clinical effect of breast-conserving surgery(BCS)combined with intraoperative radiotherapy(IORT)in early breast cancer,and discuss the clinical efficacy and indications of intraoperative radiotherapyMethods:The general clinical data of 91 patients who underwent breast-conserving surgery in the Breast Surgery Department of the Second Affiliated Hospital of Guangzhou Medical University from March 2016 to December 2018 were collected,including 56 cases of breast-conserving surgery alone,and 35 cases of breast-conserving surgery combined with intraoperative radiotherapy,follow-up through outpatient review and telephone follow-up,analyze the differences between the two groups of patients in terms of wound-related complications,radiotherapy-related side effects,cosmetic effects,recurrence and metastasis rate,evaluate the cosmetic effects of breast-conserving surgery,and discuss the clinical efficacy and indications of intraoperative radiotherapyResult:1.Wound-related complications:The rate of wound-related complications in the breast-conserving group was 10.7%,with the highest incidence of subcutaneous effusion(5.4%);the rate of wound-related complications in the breast-conserving surgery combined with intraoperative radiotherapy group was 28.6%,The higher incidence is fat liquefaction(11.4%),subcutaneous effusion(5.7%),the difference between the two groups is statistically significant,that is,the rate of wound-related complications in the breast-conserving surgery combined with intraoperative radiotherapy group is higher than that of pure breast-conserving surgery group2.Radiotherapy-related side effects:The incidence of radiotherapy-related side effects in the breast-conserving surgery group was 60.7%,including 9 cases of breast pain and edema(16.2%),and 17 cases of radiation dermatitis(30.4%);The incidence of radiotherapy-related side effects in the breast-conserving surgery combined with intraoperative radiotherapy group was 37.1%,including 4 cases of breast pain and edema(11.4%)and 6 cases of radiation dermatitis(17.1%%).The difference between the two groups was statistically significant,that is,the side effects of radiotherapy in the breast-conserving combined with intraoperative radiotherapy group is lower3.Aesthetic effect:According to objective evaluation criteria,the excellent rate of the breast-conserving surgery group is 69.6%,and the excellent rate of the breast-conserving surgery combined with intraoperative radiotherapy group is 60%,P>0.05;according to the patient's subjective self-evaluation criteria,the pure breast-conserving group's satisfaction rate was 80.4%,and the self-assessment satisfaction rate of the breast-conserving surgery combined with intraoperative radiotherapy group was 74.3%,P>0.05;that is,in terms of cosmetic effects,there was no significant difference between the two groups,and both achieved good cosmetic effects4.Recurrence and metastasis rate:During the median follow-up of 26.5 months,1 case(1.8%)of contralateral breast recurrence was found in the breast-conserving surgery group.During the median follow-up of 20 months,1 case(2.4%)of in-situ tumor recurrence was found in the breast-conserving surgery combined with intraoperative radiotherapy group,and there was no statistical difference in the local recurrence rate between the two groups there was no statistical difference in the local recurrence rate between the two groups.No distant metastases and deaths were found in both groups,and the overall survival rate was 100%Conclusion:1.The rate of wound-related complications in the breast-conserving surgery combined intraoperative radiotherapy group was higher than that in the breast-conserving surgery group,but the breast-conserving combined intraoperative radiotherapy group had lower radiation-related side effects,and the postoperative cosmetic effects of the two groups were similar2.During the current follow-up period,the breast-conserving surgery combined intraoperative radiotherapy group and the breast-conserving surgery group had similar local control rates3.For patients with low risk of recurrence,intraoperative radiotherapy can be used as radical radiotherapy,which can replace postoperative whole breast irradiation,shorten the treatment time and reduce the economic burden;for patients with medium and high risk of recurrence risk,intraoperative radiotherapy is used as a tumor bed boost,It can accurately locate the tumor bed,reduce the side effects of radiotherapy,avoid the delay of radiotherapy caused by chemotherapy,and improve the efficacy of radiotherapy.