Asgeirsson K S, Rasheed T, McCulley S J, Macmillan R D
Nottingham Breast Institute, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
Eur J Surg Oncol. 2005 Oct;31(8):817-23. doi: 10.1016/j.ejso.2005.05.010.
Breast-conserving surgery and radiotherapy is firmly established as a good and safe option for most women with early breast cancer. The important outcome measures of breast conservation are survival, local recurrence, cosmesis and patient satisfaction. Partial breast reconstructive techniques may improve cosmesis and patient satisfaction without compromising the oncological outcomes.
A search of the Medline and Pubmed databases of studies on breast conserving surgery where partial breast reconstructive techniques were employed. The keywords used were breast conserving surgery, oncoplastic breast surgery, partial breast reconstruction and reduction mammoplasty. The oncological and cosmetic outcomes of these studies were analysed.
Studies on partial breast reconstructive techniques often lack oncological outcomes and long-term results are not available. On intermediate follow-up (up to 4.5 years) local recurrence rates vary from 0 to 1.8% per year. Cosmetic failure rates vary from 0 to 18%. To date, detailed studies are small and outcome measures vary.
Breast surgeons should be aware of the range of surgical techniques that may enhance the aesthetic results of breast-conserving surgery as well as expand the indications for its use. There is a need for routine assessment of oncological and cosmetic outcomes and long-term results of partial breast reconstructive techniques in relation to these outcomes are awaited.
对于大多数早期乳腺癌女性而言,保乳手术及放疗已被确认为一种安全有效的选择。保乳的重要疗效指标包括生存率、局部复发率、美容效果及患者满意度。部分乳房重建技术可在不影响肿瘤学疗效的前提下改善美容效果及患者满意度。
检索Medline及Pubmed数据库中采用部分乳房重建技术的保乳手术相关研究。所用关键词为保乳手术、肿瘤整形乳房手术、部分乳房重建及乳房缩小成形术。分析这些研究的肿瘤学及美容学疗效。
关于部分乳房重建技术的研究往往缺乏肿瘤学疗效数据,且尚无长期结果。在中期随访(长达4.5年)中,局部复发率每年为0至1.8%不等。美容失败率为0至18%不等。迄今为止,详细研究规模较小,且疗效指标各异。
乳腺外科医生应了解一系列可提高保乳手术美学效果并扩大其应用指征的手术技术。需要对肿瘤学及美容学疗效进行常规评估,部分乳房重建技术的长期结果有待观察。