摘要目的:探讨肿瘤整形技术在早期乳腺癌保乳术的应用效果及安全性。方法:纳入2015年3月至2021年3月，湖南省郴州市第一人民医院乳甲外科收治的女性乳腺癌患者80例，年龄31～55(43±12)岁，分为整形保乳组和常规保乳组各40例。整形保乳组采用整形技术修复术后乳房局部缺损，常规保乳组采用切缘周围筋膜脂肪瓣修复局部缺损；比较两组患者手术相关指标及术后并发症的差异，并评估术后美容效果。结果:两组患者均成功完成保乳术，整形保乳组的手术时间、手术出血量、引流管留置时间均长于常规保乳组，差异均有统计学意义(均 P<0.001)，切缘2次扩切率为2.5%(1/40)，低于常规保乳组的20.0%(8/40)，差异有统计学意义( P＝0.034)。整形保乳组术后有3例皮瓣部分缺血坏死及2例皮下脂肪液化，常规保乳组有1例皮瓣部分缺血坏死及1例皮下脂肪液化，均经引流换药后愈合。术后美容效果评估显示整形保乳组优良率95%(38/40)，常规保乳组优良率70%(28/40)，差异有统计学意义( P＝0.003)。术后随访36～96个月，两组无局部复发及远处转移。 结论:整形保乳术能使早期乳腺癌患者获得更宽肿瘤切缘和更好的美容效果，安全性较好，值得临床应用。

abstractsObjective:To explore the effect of tumor plastic surgery in breast conserving surgery for early breast cancer.Methods:From March 2015 to March 2021, 80 female patients with breast cancer, aged 31 to 55 (43±12) years, who were admitted to the Department of Breast and Thyroid Surgery, the First People′s Hospital of Chenzhou City, Hunan Province, were divided into plastic breast conserving group and conventional breast conserving group, with 40 cases in each group. The plastic surgery breast conserving group used plastic surgery techniques to repair local breast defects after surgery, while the conventional breast conserving group used fascial fat flaps around the cutting edge to repair local defects; the differences in surgical related indicators and postoperative complications were compared between two groups of patients, and the postoperative cosmetic effect was evaluated.Results:Both groups successfully completed the conservative surgery. The operation time, blood loss, and drainage tube retention time in the oncoplastic conservative surgery group were longer than those in the conventional conservative surgery group, and the differences were statistically significant (all P<0.001). The 2nd cut margin expansion rate was 2.5% (1/40) in the oncoplastic conservative surgery group, which was lower than that in the conventional conservative surgery group (20%, 8/40), and the difference was statistically significant ( P=0.034). There were 3 cases of partial necrosis and 2 cases of subcutaneous fat embolism in the oncoplastic conservative surgery group after surgery, and 1 case of partial necrosis and 1 case of subcutaneous fat embolism in the conventional conservative surgery group. All of them healed after drainage and dressing changes. The postoperative aesthetic effect evaluation showed that the excellent rate in the oncoplastic conservative surgery group was 95% (38/40), and the excellent rate in the conventional conservative surgery group was 70% (28/40). The difference was statistically significant ( P=0.003). After a follow-up of 36 to 96 months, no local recurrence or distant metastasis was found in either group. Conclusions:Breast-conserving surgery can enable early breast cancer patients to achieve wider tumor margins and better aesthetic effects, with good safety and is worth clinical application.