Comparison of complications between breast-conserving surgery with free dermal fat flap and traditional breast conserving surgery in breast cancer patients / 肿瘤研究与临床

ABSTRACT

Objective:To compare the complications between breast-conserving surgery with free dermal fat graft (FDFG) and traditional breast-conserving surgery (TBCS) in breast cancer patients, and to analyze the influencing factors for the incidence of complications of breast-conserving surgery with FDFG.Methods:The clinical data of 120 breast cancer patients who underwent breast-conserving surgery with FDFG (FDFG group, 50 cases) or TBCS (TBCS group, 70 cases) in Liuzhou People's Hospital from June 2015 to September 2020 were retrospectively analyzed. The incidence of overall complications and various complications between the two groups were compared, the influencing factors of complications in the FDFG group were analyzed, and the cosmetic outcome was evaluated.Results:There was no significant difference between the two groups in age, lymph node status, clinical TNM stage, etc (all P > 0.05). In the FDFG group, the proportions of patients with the longest tumor diameter > 3 cm and tumor in upper inner quadrant were significantly higher than those in the TBCS group [52.0% (26/50) vs. 27.1% (19/70), χ2 = 7.69, P = 0.006; 38.0% (19/50) vs. 15.7% (11/70), χ2 = 7.73, P = 0.005]. The operation time, intraoperative blood loss, postoperative hospital stay and weight of resected tissues in the FDFG group were higher than those in the TBCS group [(251±69) min vs. (213±41) min, (107±29) ml vs. (68±26) ml, (8.8±2.5) d vs. (6.1±1.6) d, (81±26) g vs. (56±20) g], and the differences were statistically significant ( t values were 10.14, 30.58, 22.20, and 14.54, respectively, all P < 0.001). There were no significant differences in the incidence of overall complications, bleeding, infection, or poor wound healing between the two groups (all P > 0.05). The incidence rate fat liquefaction in the FDFG group was higher than that in the TBCS group [14.0% (7/50) vs. 1.4% (1/70), χ2 = 5.53, P = 0.019]. Multivariate logistic regression analysis showed that the weight of FDFG ( OR = 14.056, 95.0% CI 1.764-111.985, P = 0.013) and the thickness of FDFG ( OR = 19.599, 95.0% CI 1.743-220.345, P = 0.016) were independent influencing factors for the incidence of complications in the FDFG group. The percentage of 'excellent' or 'good' cosmetic outcome in the FDFG group was 90% (45/50). Conclusions:Breast-conserving surgery with FDFG can extend the resected area for tumor without increasing the incidence of overall complications and could provide patients a superior cosmetic outcome, but the incidence of fat liquefaction is higher than that of TBCS. The weight and thickness of FDFG are the influencing factors for the incidence of complications of breast-conserving surgery with FDFG.