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| Effect of breast conservative surgery combined with sentinel lymph node biopsy on the armpit extubation time, shoulder range of motion and long-term outcomes of patients with early breast cancer |
| WANG Chunshu1 LI Xin1 WEN Jian1▲ LI Pingping2 |
1.Department of Anesthesiology, the First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi Province, Xi’an 710061, China;
2.Medical Transformation Center, the First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi Province, Xi’an 710061, China |
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Abstract Objective To explore the effect of breast conservative surgery combined with sentinel lymph node biopsy on the armpit extubation time, shoulder range of motion and long-term outcomes of patients with early breast cancer. Methods The medical records of 92 cases of early breast cancer treated in the First Affiliated Hospital of Xi’an Jiaotong University from October 2015 to October 2017 were studied. Of which 44 cases received breast conservative surgery combined with sentinel lymph node biopsy (observation group) and 48 cases received modified radical mastectomy (control group). Perioperative parameters (length of operation, amount of bleeding during operation, total volume of drainage, armpit extubation time, length of stay), shoulder range of motion (outward-rotating, inward-rotating, backward extension, outreaching, bending) before and after surgery, postoperative complications, satisfaction with the result of breast cosmetology, scores of the specific questionnaire to patients with breast cancer after surgery (QLQ-BR23), and results of the follow-up survey of patients in two groups were compared. Results The operation time of observation group was longer than that of control group, the intraoperative blood loss and total drainage volume of observation group were less than those of control group, the axillary extubation time and hospitalization time of observation group were shorter than those of control group, the differences were statistically significant (P < 0.05). Six months after operation, the external rotation, internal rotation, extension, abduction and flexion of shoulder joint in two groups were decreased compared with those before operation (P < 0.05), but observation group was larger than that of control group (P < 0.05). The incidence of complication in observation group was lower than that in control group (P < 0.05). The satisfaction of breast beauty in observation group was higher than that in control group six months after operation (P < 0.05). The reliability and validity of the self-made questionnaire of breast beauty satisfaction: Cronbach’s α coefficient was 0.854, test-retest reliability was 0.836. The content validity index was 0.817. The scores of body image, sexual function, sexual pleasure and future view in observation group were higher than those in control group six months after operation, while the scores of breast symptoms and upper limb symptoms in observation group were lower than those in control group (P < 0.05). There were no significant differences in the scores of hair loss and side effects between two groups (P > 0.05). Followed up for one year, there were no significant differences in survival rate, recurrence rate and metastasis rate between two groups (P > 0.05). Conclusion The treatment of breast conservative surgery combined with sentinel lymph node biopsy can produce a therapeutic effect close to that of modified radical mastectomy in patients with early breast cancer, while having such advantages as faster recovery after operation and smaller impact on the appearance and activities of daily living of the breasts.
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