观察保留乳头乳晕的改良根治术联合假体即刻置入术治疗早期乳腺癌的临床价值。

回顾性分析93例乳腺癌患者的临床资料，根据患者手术方案不同分为假体置入组(采取改良根治术联合假体置入术，n＝48)与传统手术组(行传统改良根治术，n＝45)。应用统计学软件SPSS19.0处理数据，两组年龄、肿瘤直径、体重指数采用(±s)表示，行独立样本t检验；TNM分期、乳房外观优良率、术后心理状况及生活质量、并发症总发生率采取χ²检验，P<0.05为差异有统计学意义。

假体置入组与传统手术组并发症总发生率分别为25.0%与20.0%(P>0.05)。假体置入组术后3个月的乳房外观优良率为93.8%，显著高于传统手术组77.8%(P<0.05)。假体置入组术后6个月的焦虑、抑郁、恐惧、人际敏感、自我形象紊乱发生率分别为25%、16.7%、31.3%、20.8%、14.6%，显著低于传统手术组的46.7%、35.6%、53.3%、40%、33.3%(P<0.05)。两组2年无瘤生存率、随访期间复发率、转移率、死亡率均无统计学意义(P>0.05)。

保留乳头乳晕的改良根治术联合假体置入术治疗早期乳腺癌可满足患者乳房重建的需求，不影响根治效果且提高了患者乳房外形美观度，患者术后心理与生活质量得到改善，值得推广。

To observe the clinical value of modified radical with nipple-sparing mastectomy combined with immediate prosthesis implantation for early stage breast cancer.

The clinical data of 93 patients with early stage breast cancer treated in our hospital were retrospectively analyzed and divided into prosthesis implantation group (treated with modified radical mastectomy and immediate prosthesis implantation, n=48) and traditional surgery group (treated with traditional modified radical mastectomy, n=45) according to the different surgical procedures. The data was analyzed using the statistical software SPSS19.0. The age, tumor diameter, body mass index of the two groups were adopted by (±s) and compared by the independent sample t test; The TNM stage, the excellent and good rate of breast appearance, postoperative mental status and quality of life, total incidence of complications of the two groups were compared by χ² test, P<0.05 was considered statistically significant.

The total complication rate in the prosthesis implantation group and the traditional surgery group were 25.0% and 20.0% (P>0.05). The excellent and good rate of breast appearance in the prosthesis implantation group was 93.8% at 3 months postoperatively, which was significantly higher than 77.8% in the traditional surgery group (P<0.05). The incidence of anxiety, depression, fear, interpersonal sensitivity and self-image disorder in the prosthesis implantation group were 25%, 16.7%, 31.3%, 20.8%, 14.6% at 6 months after operation, which were significantly lower than 46.67% and 46.7%, 35.6%, 53.3%, 40%, 33.3% in the traditional surgery group (P<0.05). There were no significant difference in the 2-year disease-free survival rate, the recurrence rate and distant metastasis rate, mortality rate during follow-up between the two groups (P>0.05).

The modified radical with nipple-sparing mastectomy combined with immediate prosthesis implantation in the treatment of early breast cancer can meet the needs of patients with breast reconstruction, which does not affect the curative effect and can improve the aesthetic of breast appearance, improve the patient’s postoperative psychological and quality of life, is worthy of promoting.