Bilateral mammoplasty for cancer: Surgical, oncological and patient-reported outcomes
Bilateral mammoplasty for cancer: Surgical, oncological and patient-reported outcomes
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DOI：
10.1016/j.ejso.2016.08.013
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发表时间：
2017-01-01
期刊：
影响因子：
3.8
通讯作者：
Rusby, J. E.
中科院分区：
文献类型：
--
作者：
Di Micco, R.;O'Connell, R. L.;Rusby, J. E.
前言：双侧乳房成形术(BM)可以优化巨大或下垂乳房的肿瘤安全性和美容效果，这些女性的肿瘤与乳房体积比或肿瘤位置对标准的保乳治疗(BCT)构成了挑战，对她们来说，乳房切除(或重建)可能是唯一的替代方案。方法：我们对自2009年6月至2014年11月接受BM治疗乳腺癌(BC)的女性的手术结果(根据Clavien Dindo分类的并发症)、急性放射并发症(放射治疗肿瘤学分组分类)、肿瘤学结果和患者满意度(Break-Q调查问卷)进行了全面分析。中位年龄55岁(范围33-84)，中位肿瘤大小成像35 mm(范围0-170)。样本重量中位数为242g(范围39-1824)。87.5%的手术采用了WISE模式技术。68例(40.5%)出现至少一种并发症，多数为Clavien Dindo 1级。3级并发症很少见(8.9%)，但主要发生在治疗性乳房整形术(TM)侧(p<；0.05)。并发症与较高的BMI、标本重量和较长的放射治疗时间有关(p<；0.05)。中位随访期37个月(范围13-77个月)。局部复发3例(1.8%)，远处转移5例(3.0%)，死亡10例(6.0%)。乳房满意度评分的中位数为77分(范围为0-100)。结论：这项研究同时提供了手术、肿瘤和患者报告结果的数据。它提供的证据表明，BM是治疗大乳房或下垂乳房女性乳腺癌的有效方法。(C)2016爱思唯尔有限公司、类似于癌症外科协会的BASO和欧洲外科肿瘤学学会。版权所有。
Introduction: Bilateral mammoplasty (BM) can optimise oncological safety and aesthetic outcomes in women with large or ptotic breasts whose tumour to breast volume ratio or tumour location pose a challenge to standard breast-conserving therapy (BCT) and for whom mastectomy (with or without reconstruction) may be the only alternative.Methods: We undertook a comprehensive analysis of surgical outcomes (complications according to the Clavien Dindo classification), acute radiation morbidity (Radiation Therapy Oncology Group classification), oncological outcomes, and patient satisfaction (BREAST-Q questionnaire) in women who underwent BM for breast cancer (BC) from June 2009 November 2014.Results: 168 women were included. Median age was 55 years (range:33-84) and median tumour size at imaging 35 mm (range:0-170). Median specimen weight was 242 g (range 39-1824). The wise pattern technique was used in 87.5% of procedures. At least one complication occurred in 68 (40.5%) women, mostly Clavien Dindo grade 1. Grade 3 complications were infrequent (8.9%) but occurred mainly on the therapeutic mammoplasty (TM) side (p < 0.05). Complications were associated with higher BMI, specimen weight and longer time to radiotherapy (p < 0.05). Median follow-up was 37 months (range: 13-77). Local recurrence occurred in 3 (1.8%), distant metastases in 5 (3.0%), and 10 (6.0%) women have died. The median score for 'satisfaction with breasts' was 77 (range: 0-100).Conclusions: This study provides concurrent data on surgical, oncological and patient-reported outcomes. It offers evidence that BM is an effective treatment for breast cancer in large- or ptotic-breasted women. (C) 2016 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.