关键词: 乳腺癌, 乳腺癌改良根治术, 胸大肌, 胸前神经, 肌电图

Abstract: Objective To assess the pectoralis major muscle function after modified radical mastectomy by muscle strength,ultrasonogram and electromyogram,and also with an evaluation of the significance of preservation of the anterior thoracic nerve.Methods Fourty-six patients with breast cancer who had undergone modified radical mastectomy from Jan 2001 to Dec 2003 were analyzed retrospectively.The patients were divided into four groups:incomplete preservation of the anterior thoracic nerve+Auchincloss's operation group(n=13),incomplete preservation of the anterior thoracic nerve+Patey's operation group(n=7),complete preservation of the anterior thoracic nerve+Auchincloss's operation group(n=20),complete preservation of the anterior thoracic nerve+Patey's operation group(n=6) group.Incomplete preservation of the anterior thoracic nerve was defined as the medial pectoral nerve or lateral pectoral nerve being partially injured.The function of the pectoralis major muscle was assessed by examination of the ipsilatera upper limb muscle strength,ultrasonogram and electromyogram 3 months or longer after surgery.The results were analysed with the aid of SPSS 10.0 statistics software,P<0.05 is considered as statistically significant.Results There was no difference in the strength of pectoralis major muscle among different groups by the muscle strength evaluation.Ultrasonogram and electromyogram examination however,showed signifcant differences statistically in favour of the groups with the anterior thonacic nerve completely preserved.Conclusion The measurement of muscle strength is unable to accurately evaluate the function of pectoralis major muscle after modified radical mastectomy.However,ultrasonogram and electromyogram are able to examine the function of the pectoralis major muscle much better.Furthermore,the results also indicate that it is very important to completely preserve the anterior thoracic nerve in modified radical mastectomy.

Key words: breast carcinoma, modified radical mastectomy, pectoralis major muscle, anterior thoracic nerve, electromyogram