| Background and Purpose: As the treatment of breast cancer in China is improving,the deformity caused by the loss of breast and the resulting psychological disorders have gradually received attention.For early breast cancer,breast conserving surgery has become an important part of surgical treatment at present.Although the overall“acceptable” cosmetic results are good,breast conserving surgery still causes breast deformities(such as asymmetry of both breasts)in most patients.Autologous fat grafting(AFG)is a technique that transfers autologous fat from a distant anatomical site to the part of the breast and restores the shape and volume of the breast with minimal trauma.AFG has good aesthetic effect in improving local defect and deformity after breast conserving surgery and breast reconstruction.However,there are few studies on breast-conserving surgery(BCS)combined with immediate AFG,and there are still controversies on the oncologic safety,long-term aesthetic stability and postoperative breast imaging changes of this technique.Consequently,the purpose of our study is to observe the effects of BCS combined with immediate AFG on oncologic safety,satisfaction and psychology of breast cancer patients.Patients and methods: In the study,we retrospectively collected the data of 98 breast cancer patients who received treatment in the Breast Diagnosis and Treatment Center of The Affiliated Hospital of Qingdao University from February 2018 to December 2018.After screening and using propensity score match,42 patients in the AFG group(AG)and42 patients in the control group(CG)were finally included in the study.In this study,outpatient follow-up was conducted 2 months after discharge,and telephone follow-up was conducted every 6 months.BREAST-Q-BCT breast satisfaction questionnaire version 2.0 was used from the first postoperative follow-up,and the patients were regularly followed up for a long time.Finally,the equivalent score was used for analysis.At the same time,Self-Rating Depression Scale(SDS)was used to assess the depression status of patients,and Self-Rating Anxiety Scale(SAS)was used to assess the anxiety status of patients.Finally,the grading degree was used as the evaluation result.The primary outcomes were the results related to tumor safety(survival,tumor recurrence and metastasis)and patients’ satisfaction with postoperative breast appearance(breast-Q score).The secondary outcomes were postoperative complications and psychological related conditions.The short-term complications include infection,bleeding,subcutaneous effusion,flap necrosis,upper limb edema.The long-term complications include calcification,cyst,fat liquefaction,necrosis.Psychological related conditions include depression and anxiety.Results: 84 patients were included in the analysis.There was no statistically significant difference in the clinical and pathological data between the two groups(P>0.05).The average follow-up time of the two groups was 42.14±3.08 and 41.12±2.62 months,respectively.In the analysis of oncologic safety,no patients died in AG and 1 patient died in CG.In addition,there was no statistically significant difference between the two groups in terms of the overall recurrence rate and the distribution of recurrence types(P>0.05).As for satisfaction,the BREAST-Q score of AG was significantly higher than that of CG(58.00±4.77 vs 51.88±5.38,P<0.001).In the secondary outcomes,there was no short-term complication specified in the study was found;in the long-term complications,the incidence of calcification in AG was significantly higher than that in CG(P=0.021).There was no statistically significant difference between the two groups in the degree of depression and anxiety(P>0.05).Conclusion: BCS combined with immediate AFG can significantly improve patients’ satisfaction without increasing the risk of death and tumor recurrence.However,it does not seem to play a role in improving the conditions of depression and anxiety. |
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