Singh Gurpreet, Sharma Ramesh K
Department of Surgery, Postgraduate Institute of Medical Education and Research (P.G.I.M.E.R.), Chandigarh, India.
Breast. 2008 Jun;17(3):296-301. doi: 10.1016/j.breast.2007.11.005. Epub 2007 Dec 21.
Phyllodes tumors are rare breast tumors. Surgery is the mainstay of treatment and mastectomy has been the traditional procedure adopted for these tumors. Although wide excision with adequate margins gives equivalent results, mastectomy may still be required if the tumors are very large. There are very few reports on the use of breast reconstruction after mastectomy for phyllodes tumors. We present a series of 7 patients with phyllodes tumors who were treated with mastectomy and immediate breast reconstruction. Mastectomy was conventional in 4 patients and skin sparing in 3. Reconstruction was performed with latissimus dorsi (LD) musculocutaneous flap in 4 patients and transverse rectus abdominis musculocutaneous (TRAM) flap in 3 patients. The mean follow-up was 40.1 months. One patient developed recurrence, 1 year after the surgery, which was treated with excision and radiotherapy. The cosmetic results were acceptable to all patients. Skin sparing mastectomy was associated with better cosmetic results.
叶状肿瘤是一种罕见的乳腺肿瘤。手术是主要的治疗方法，乳房切除术一直是针对这些肿瘤采用的传统术式。尽管切缘足够的广泛切除能取得相同的效果，但如果肿瘤非常大，仍可能需要进行乳房切除术。关于叶状肿瘤乳房切除术后进行乳房重建的报道非常少。我们报告了7例接受乳房切除术并即刻乳房重建的叶状肿瘤患者。4例患者采用传统乳房切除术，3例采用保乳皮肤乳房切除术。4例患者用背阔肌（LD）肌皮瓣进行重建，3例患者用腹直肌横形肌皮（TRAM）瓣进行重建。平均随访时间为40.1个月。1例患者在术后1年出现复发，经切除和放疗治疗。所有患者对美容效果均满意。保乳皮肤乳房切除术的美容效果更好。
