目的：探讨保留乳头乳晕复合体（NAC）的乳腺癌改良根治术并一期乳房重建术治疗早期乳腺癌的安全性及可行性。方法：将2010—2014 年乳腺癌患者170 例，根据患者意愿分别行保留NAC 的乳腺癌改良根治术并一期乳房重建术（观察组，102 例），与未保留NAC 的皮下乳腺癌改良根治术（对照组，68 例）。比较两组术后相关指标、患者对乳房重建的满意度、生活质量情况及随访期间不良事件以及复发、转移发生率。结果：两组术后创面引流时间及引流量无统计学意义差异（均P>0.05）。观察组患者术后满意率（97.06% vs.51.47%）、FACT 总评分（150.89±25.34） vs. (100.24±18.47）、生活质量高水平率（83.33% vs.51.47%）均高于对照组（均P<0.05）。两组不良事件发生率、远处转移率及复发率相似，组间无统计学差异（均P>0.05）。结论：保留NAC 的改良根治术并一期乳房重建术治疗早期乳腺癌安全、可行，且在术后美学效果、改善患者生活质量方面明显优于未保留NAC 的皮下乳腺癌改良根治术。
Clinical efficacy of nipple-areola complex sparing modified radical mastectomy with first-stage breast reconstruction in treatment of early breast cancer
Objective: To investigate the safety and feasibility of the nipple complex (NAC) sparing modified mastectomy with first-stage breast reconstruction in treatment of early breast cancer. Methods: During 2010 to 2014, 170 breast cancer patients, according to their own choice, received NAC sparing modified mastectomy with first-stage breast reconstruction (observational group, 102 cases), or modified subcutaneous mastectomy with NAC removal (control group, 68 cases), respectively. The relevant postoperative parameters and postoperative patient’s satisfaction with breast reconstruction and quality of life as well as the incidence of adverse events, recurrence and metastasis during follow-up of the two groups were compared. Results: The duration and volume of wound drainage showed no significant difference between the two groups (both P<0.05); the postoperative patient satisfaction rate (97.06% vs. 51.47%), overall FACT score (150.89±25.34) vs. (100.24±18.47) and high satisfaction rate (83.33% vs. 51.47%) in observational group were significantly higher than those in control group (all P<0.05); there was no significant difference in incidence of adverse events, local recurrence and distant metastasis between the two groups (all P>0.05). Conclusion: NAC sparing modified mastectomy with first-stage breast reconstruction is safe and feasible for early breast cancer, and it is evidently superior to modified subcutaneous mastectomy without NAC preservation with regard to postoperative cosmetic results and improving patient’s quality of life.