Abstract: Objective To investigate the efficacy and cosmetic results of periareolar incision combined with mastoscopic axillary lymph node dissection (MALND)in breast conserving surgery (BCS)for early breast cancer. Methods From January 2016 to January 2019, 98 patients with early breast cancer received breast conserving surgery, of whom 46 cases (periareolar incision group) received periareolar incision and MALND,52 cases (tumor surface incision group)received tumor surface incision and conventional axillary lymph node dissection(CALND)in the same period.The surgical observation indicators such as the operative time,bleeding,drainage tube time,hospital stay were compared between the two groups.The cosmetic results of breast were evaluated according to the appearance of breast more than 6 months after operation. Results There was no significant difference in tumor size, tumor location, distance between tumor and nipple-areola complex(NAC), lymph node metastasis, pathological type, clinical stage and molecular type between the two groups(P>0.05). The operation time was shorter in the tumor surface incision group (P<0.05). There was no significant difference in bleeding, drainage tube time,hospital stay between the two groups (P>0.05). The scores of texture and elasticity, symmetry, degree of breast depression, skin color, surgical scar and breast compliance in the periareolar incision group were higher than those in the tumor surface incision group (P<0.05). The excellent and good rate of total score greater than 24 in the periareolar incision group (78.3%, 36/46) was significantly higher than that in the tumor surface incision group (51.9%, 27/52), the difference was significant (P<0.05). Conclusion The BCS effect is the same as that of the tumor surface incision when the tumor is removed through the periareolar incision. Combined with MALND technology, the operation effect of BCS for early breast cancer and the postoperative quality of life of patients are improved, and the best cosmetic results is obtained.

Key words: breast cancer, breast conserving surgery, periareolar incision, mastoscopic axillary lymph node dissection, cosmetic results