Abstract: Objective To investigate the effect of vacuum-assisted excision and open surgery on breastfeeding capability of breast fibroadenoma patients. Methods A total of 264 patients with unilateral single fibroadenoma resection in the Breast Disease Center of Guangdong Women and Children's Hospital from January 2014 to December 2017 were screened. Breastfeeding questionnaire was conducted to the patients, and related factors affecting postoperative breastfeeding were analyzed. Results All patients were successfully breast-fed after operation, but the capability varies among different patients.In the general population, galactostasis was more likely to occur on the operative side than on the healthy side, and in 76.8% （63/82） of the patients with galactostasis on the operative side, the galactostasis quadrant was consistent with the preoperative tumor location. Chi-square analysis showed that preoperative tumor location quadrant, surgical method and time between operation and lactation had no significant effects on the occurrence of galactostasis on the operative side, and the differences were not statistically significant （P>0.05）; However, multivariate Logistic regression showed that preoperative tumor size, distance from the tumor center to the nipple, distance between the incision and the nipple and conditions of the operative side nipple were important factors affecting the occurrence of galactostasis and reduced milk yield, with statistical significance （P<0.05）. Conclusion After the operation of breast fibroadenoma, all patients were successfully breast-fed, but the operative side is more prone to galactostasis than the healthy side. The size of the tumor, the distance from the tumor center to the nipple, the distance between the incision and the nipple, and the conditions of the operative side nipple are important factors affecting the occurrence of galactostasis.

Key words: breast fibroadenoma, vacuum-assisted excision, open surgery, breastfeeding capability

摘要： 目的 探讨乳腺纤维腺瘤真空辅助旋切与开放手术对患者泌乳功能的影响。方法 筛选2014年1月~2017年12月于广东省妇幼保健院乳腺疾病防治中心行单侧单发乳腺纤维腺瘤切除手术,术后对其进行母乳喂养问卷调查,分析影响患者术后哺乳的相关因素。结果 共264例患者入组,患者术后均可成功进行乳母喂养,但不同患者之间,泌乳能力有所差别。总体人群哺乳期术侧与健侧相比,更容易发生乳汁淤积,其中术侧发生乳汁淤积的患者中有76.8%（63/82）患者乳汁淤积象限与术前肿瘤所在象限一致。术前肿瘤所在象限、手术方式、手术距哺乳间隔时间对于术侧是否发生乳汁淤积及术侧泌乳量的变化无明显影响,差异均无统计学意义（P>0.05）;然而,多因素Logistic回归筛选得出：术前肿瘤大小、肿瘤中心距乳头距离、手术切口距乳头距离以及术侧乳头条件是影响患者术后发生乳汁淤积及泌乳量减少的重要因素,差异具有统计学意义（P<0.05）。结论 乳腺纤维腺瘤术后,术侧乳房相较于健侧更容易发生乳汁淤积,术前肿瘤大小、肿瘤距乳头距离、手术切口距乳头距离以及术侧乳头条件是患者发生乳汁淤积及泌乳量减少的可能影响因素。

关键词: 乳腺纤维腺瘤, 微创手术, 开放手术, 泌乳功能