Nakamura Rikiya, Nagashima Takeshi, Sakakibara Masahiro, Sangai Takafumi, Fujimoto Hiroshi, Arai Manabu, Shida Takashi, Kaneoya Katsuhiko, Ueda Takuya, Nakatani Yukio, Hashimoto Hideyuki, Miyazaki Masaru
Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-0856, Japan.
Breast. 2008 Jun;17(3):245-51. doi: 10.1016/j.breast.2007.10.007. Epub 2007 Nov 19.
Success of breast-conserving surgery (BCS) following neoadjuvant chemotherapy (NAC) depends on accurate assessment of the initial lesion. We developed a new procedure (NIPR) in which initial naked magnetic resonance images are projected onto the skin before BCS.
Thirty-five breast cancer patients underwent supine oblique MRI of the operative area. In 20 DCIS patients, the metallic clips were reproduced by projection on the skin using NIPR, and discrepancies between the projection site and clip were measured on X-rays. Fifteen patients (T1;3,T2;8,T3;4 cases) treated with NIPR were compared to 20 (T1;5 , T2;15 cases) treated using the conventional method with regard to excision area and additional excision rate of BCS after NAC.
The median discrepancy (linear distance) was 2.6 mm. NIPR significantly reduced the excision area and additional excision rate in T1 and T2 compared to the conventional method (P<0.05).
NIPR is a reliable technique for BCS following NAC with significant reductions in excision area and additional excision rate and superior cosmetic results.
新辅助化疗（NAC）后保乳手术（BCS）的成功取决于对初始病灶的准确评估。我们开发了一种新方法（NIPR），即在BCS前将初始的裸磁共振图像投影到皮肤上。
35例乳腺癌患者接受了手术区域的仰卧斜位MRI检查。在20例导管原位癌（DCIS）患者中，使用NIPR通过皮肤投影重现金属夹，并在X射线上测量投影部位与夹子之间的差异。将15例接受NIPR治疗的患者（T1期3例、T2期8例、T3期4例）与20例采用传统方法治疗的患者（T1期5例、T2期15例）在NAC后BCS的切除面积和额外切除率方面进行比较。
中位差异（直线距离）为2.6毫米。与传统方法相比，NIPR在T1期和T2期显著降低了切除面积和额外切除率（P<0.05）。
NIPR是NAC后进行BCS的可靠技术，可显著降低切除面积和额外切除率，并具有更好的美容效果。
