To explore efficacy of breast-conserving surgery (BCS) combined with endoscopic axillary lymph node dissection (EALND) in the treatment of early breast cancer.

A total of 60 patients with early breast cancer in the Department of General Surgery, Karamay Central Hospital from July 2009 to July 2011 were enrolled for a prospective study. The patients were divided into three groups according to their wishes: BCS+ EALND group (16 cases), BCS group (20 cases) and modified radical mastectomy (MRM) group (24 cases). χ² test and the Fisher exact test was used to compare the dysfunction, lymphedema, pain and paresthesia of limbs, incision scar, local recurrence, distant metastasis, mortality and cosmetic effect across three groups at 1, 3 and 5 years after surgery.

The local recurrence rate and mortality were 1/16 and 1/16 in BCS+ EALND group, 5.0%(1/20) and 5.0%(1/20)in BCS group, 4.2%(1/24) and 4.2%(1/24) in MRM group. No significant difference was found in the local recurrence rate and mortality across three groups (P=1.000). At one year after surgery, the incidence of incision scar in three groups was 0, 60.0%(12/20) and 100%(24/24)( χ²=40.000, P<0.001), and incidence of limb paresthesia was 1/16, 30.0%(6/20) and 50.0%(12/24)(χ²=8.530, P=0.014), and the difference was statistically significant across three groups. At 3 years after surgery, the incidence of movement dysfunction was 0, 0, 29.2%(7/24)(P=0.002), the incidence of incision scar was 0, 50.0%(10/20), 91.7%(22/24)(χ²=32.545, P<0.001), the incidence of limb paresthesia was 0, 10.0%(2/20), 33.3%(8/24) (P=0.011), and the difference was statistically significant across three groups. At 5 years after surgery, the incidence of movement dysfunction was 0, 0, 25.0%(6/24) (P=0.007), the incidence of incision scar was 0, 45.0%(9/20), 83.3%(20/24)( χ²=27.609, P<0.001), the incidence of limb paresthesia was 0, 10.0%(2/20), 33.3%(8/24) (P=0.011), and the difference was statistically significant across three groups. At 1, 3 and 5 years after surgery, the occurrence of incision scar in BCS+ EALND group was significantly lower than that in BCS group (P<0.001, 0.001, 0.002) or MRM group (both P<0.001); the incidence of other complications in BCS+ EALND group was similar to that in BCS group while the occurrence of limb paresthesia in BCS+ EALND group was significantly lower than that in MRM group (P=0.005, 0.013, 0.013). There was significant difference in the complication rate across three groups at 1, 3 and 5 years after surgery (χ²=32.237, 31.917, 16.481, all P<0.001); the complication rate in BCS+ EALND group was significantly lower than that in BCS group at 1 and 3 years after surgery (Bonferroni correction: P=0.001, 0.009). There was no significant difference in cosmetic effect between BCS+ ELAND group and BCS group (P =0.715).

BCA combined with EALND has the advantages of less surgical trauma, fewer complications and less visible incision scar, without increasing the rate of recurrence and metastasis.