Meretoja T J, von Smitten K A J, Leidenius M H K, Svarvar C, Heikkilä P S, Jahkola T A
Department of Plastic Surgery, Helsinki University Central Hospital, P.O. Box 266, FI-00029 HUS, Helsinki, Finland.
Eur J Surg Oncol. 2007 Dec;33(10):1142-5. doi: 10.1016/j.ejso.2007.03.022. Epub 2007 May 8.
Since the introduction of skin-sparing mastectomy (SSM) in 1991 concerns on local control and recurrence rates have been discussed in the literature. The aim of this study is to examine in particular incidence of local recurrence in a 15-year consecutive series of breast cancer patients having undergone SSM and immediate breast reconstruction (IBR) at a single population-based institution.
One hundred and forty-six consecutive patients with either stage 1 or 2 breast cancer who underwent SSM followed by IBR from 1992 to 2006 were included in this study. A retrospective review of patient records was conducted.
During a mean follow-up time of 51 months, four local recurrences of the native breast skin were accounted for. In addition, three regional lymph node recurrences and four systemic recurrences took place. All of the local and regional recurrences were handled by salvage surgery followed by adjuvant oncological therapies. During a mean follow-up of 35 months after the detection and treatment of the locoregional recurrences none of the patients developed new recurrences.
Our present study concludes that SSM followed by IBR seems oncologically sound procedure for stage 1 and 2 breast cancer patients. In addition, local recurrences and regional lymph node recurrences are not always associated with systemic relapse.
自1991年引入保乳皮肤乳房切除术(SSM)以来,文献中已对局部控制和复发率问题进行了讨论。本研究的目的是特别调查在一家基于单一人群的机构中,连续15年接受SSM及即刻乳房重建(IBR)的乳腺癌患者的局部复发发生率。
本研究纳入了1992年至2006年间连续146例接受SSM并随后进行IBR的I期或II期乳腺癌患者。对患者记录进行了回顾性分析。
在平均51个月的随访期内,发现了4例原乳房皮肤的局部复发。此外,发生了3例区域淋巴结复发和4例全身复发。所有局部和区域复发均通过挽救性手术及辅助肿瘤治疗进行处理。在局部区域复发的检测和治疗后的平均35个月随访期内,没有患者出现新的复发。
我们目前的研究得出结论,对于I期和II期乳腺癌患者,SSM联合IBR似乎是一种肿瘤学上合理的手术方式。此外,局部复发和区域淋巴结复发并不总是与全身复发相关。