Wang Sheng-Ying, Lu Zhi, Cheng Xin-De, Zhang Rong-Xin, Zhang Zong-Xin, Tian Huai-Gao, Han Fu-Sheng, Deng Jun
Department of Surgical Oncology, Cancer Hospital of Anhui Province, Bengbu, Anhui, 233004, P.R.China.
Ai Zheng. 2004 Jan;23(1):56-9.
BACKGROUND & OBJECTIVE: Modified radical mastectomy (MRM) operation has become an important surgical therapy for early stage breast cancer, but how to reconstruct breast and preserve nipple-areolar complex (NAC) is controversial. In this study, we applied a modified radical mastectomy for early stage breast cancer for preserving NAC and breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap.
During operation we performed the subcutaneous glandular excision and axillary dissection, and reconstructed the breast using TRAM flap in 10 patients with early stage breast cancer; meanwhile, maximam extent of breast skin and NAC were preserved.
The appearance of the reconstructed breast was better preserved after operation. No local recurrence and distant metastasis occurred in the patients during the follow up time (range 24-48 months). No skin flap necrosis, atrophy, and scleroses surround the NAC were observed; and no abdominal wall hernia occurred at the donor site. The nipple sensation was recovered half a year after surgery.
Modified radical operation for preserving NAC and breast reconstruction using TRAM flap may be a better way for breast cancer patients in early stage who request well preserving of breast. More samples are needed for proving the effects of this operation.
改良根治性乳房切除术(MRM)已成为早期乳腺癌的重要手术治疗方法,但如何进行乳房重建及保留乳头乳晕复合体(NAC)仍存在争议。在本研究中,我们对早期乳腺癌患者应用改良根治性乳房切除术以保留NAC,并采用腹直肌肌皮瓣(TRAM瓣)进行乳房重建。
术中对10例早期乳腺癌患者行皮下腺体切除及腋窝清扫,并用TRAM瓣进行乳房重建;同时,最大限度保留乳房皮肤及NAC。
术后重建乳房外观保存较好。随访期间(24~48个月)患者无局部复发及远处转移。未观察到皮瓣坏死、萎缩,NAC周围无硬化;供区未发生腹壁疝。术后半年乳头感觉恢复。
采用保留NAC的改良根治手术并应用TRAM瓣进行乳房重建,对于要求良好保留乳房的早期乳腺癌患者可能是一种较好的方法。尚需更多样本以证实该手术的效果。