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目的:探讨乳腺癌患者行乳腺癌改良根治术中保留胸前神经(ATN)和肋间臂神经(ICBN)的可行性及临床意义。方法:在125例Ⅰ、Ⅱ期乳腺癌患者中,行改良根治术时完整保留ATN和ICBN65例,切除60例。比较两组患者术后胸肌萎缩情况和上臂内侧及腋窝部皮肤感觉功能。结果:保留ATN和ICBN组65例,重度胸肌萎缩2例。切除组60例,重度胸肌萎缩16例,两组间差异有统计学意义(P<0.05)保留ATN和ICBN组,上臂内侧及腋窝皮肤感觉异常6例。切除组38例,两组间差异有统计学意义(P<0.05)。随访3～56月,两组均无肿瘤局部复发和远处转移。结论:保留胸前神经(ATN)和肋间臂神经(ICBN)在Ⅰ、Ⅱ期乳腺癌改良根治术中是安全可行的,能有效减少患者胸肌萎缩,保留上臂内侧及腋窝皮肤感觉功能,提高患者术后生活质量。
Objective: To investigate the feasibility and clinical significance of preserving the anterior chest nerve (ICN) and intercostobrachial nerve (ICBN) in patients with breast cancer undergoing modified radical mastectomy. Methods: In 125 patients with stage Ⅰ and Ⅱ breast cancer, 65 cases were completely preserved by modified radical mastectomy and 60 cases were resected. Pectoral muscle atrophy and sensory function in the medial upper arm and armpit were compared between the two groups. Results: 65 cases of ATN and ICBN were reserved, 2 cases of severe chest muscle atrophy. 60 cases of resection group and 16 cases of severe chest muscle atrophy. The difference between the two groups was statistically significant (P <0.05). The ATN and ICBN group were retained, and the sensation of the inner arm and axillary skin was abnormal in 6 cases. There were 38 cases in the resection group, the difference between the two groups was statistically significant (P <0.05). All cases were followed up for 3 ~ 56 months. There was no local tumor recurrence and distant metastasis in both groups. CONCLUSION: It is safe and feasible to preserve the anterior chest nerve (ICN) and the anterior intercostal nerve (ICBN) in the modified radical mastectomy of stage Ⅰ and Ⅱ breast cancer, which can effectively reduce the chest muscle atrophy, maintain the sensory function of the medial upper arm and axillary skin, Postoperative quality of life of patients.