Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery.
Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery.
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DOI：
10.1007/s00238-013-0922-4
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发表时间：
2014
影响因子：
0.5
通讯作者：
Svensson, Henry
中科院分区：
文献类型：
--
作者：
Rose, Michael;Manjer, Jonas;Ringberg, Anita;Svensson, Henry
乳腺癌整形外科是一门不断发展的学科，旨在改善乳腺癌的手术治疗结果。2008年1月至2010年12月期间，对72名患有74例乳腺癌的女性进行了乳腺癌整形手术，这些女性选自1，018名原发性乳腺癌患者。仔细的术前计划显示，根据乳房大小以及肿瘤大小和位置，可能进行部分乳房重建，包括体积缩小、体积置换或体积置换。数据连续登记。手术计划在所有病例中均获得成功，但有一例病例在初次手术期间必须进行乳房切除术。在53例病例中，在手术过程中进行了对侧乳房成形术以实现对称。在2011年11月之前的随访期间，只有1例患者需要进行矫正手术。最后的组织病理学检查表明，7例需要扩大切除术，3例需要乳房切除术。5例患者出现伤口延迟愈合，尽管4例患者的重建乳房、3例患者的对侧乳房和2例患者的腋窝因血肿而发生了需要进一步手术的并发症。这些并发症导致4例患者的辅助治疗轻微延迟。这项研究表明，它是可行的，实施肿瘤整形乳房手术到日常临床实践中，作为传统的乳腺癌手术的补充。因此，在形状和对称性方面，乳房肿瘤整形手术可能比保乳手术提供明显更好的结局，而不会影响手术边缘。证据等级：IV级，预后/风险研究。
Oncoplastic breast surgery is an evolving discipline in the surgical treatment of breast cancer aimed to improve the outcome. Oncoplastic breast surgery was performed between January 2008 and December 2010 on 72 women with 74 breast cancers selected from a population of 1,018 primary breast cancer patients. Careful preoperative planning revealed the possibility of partial breast reconstruction with volume reduction, volume displacement or volume replacement depending on breast size as well as tumour size and location. Data were registered consecutively. The surgical plan was successful in all but one case, where a mastectomy had to be performed during the primary surgery. In 53 cases, a contralateral mammoplasty was performed during the operation to achieve symmetry. During the follow-up period until November 2011, only one patient needed corrective surgery. Final histopathological examination indicated that seven cases required extended resection and three cases required a mastectomy. Five patients experienced delayed wound healing, although complications requiring further surgery occurred for the reconstructed breast in four cases, the contralateral breast in three cases and the axilla after exaeresis in two cases because of haematoma. Such complications led to slight delay in adjuvant therapy for four patients. This study demonstrates that it is feasible to implement oncoplastic breast surgery into daily clinical practice as a supplement to conventional breast cancer surgery. As such, oncoplastic breast surgery may provide a markedly better outcome than breast-conserving surgery in terms of shape and symmetry without compromising the surgical margins. Level of Evidence: Level IV, prognostic/risk study.