Cothier-Savey Isabelle, Rimareix Françoise
Service de chirurgie du centre de lutte contre le cancer René-Huguenin, 35, rue Dailly, 92210 Saint-Cloud, France.
Ann Chir Plast Esthet. 2008 Apr;53(2):102-11. doi: 10.1016/j.anplas.2007.11.004. Epub 2008 Mar 26.
After a conservative treatment for breast cancer, 75% of patients end up with a good aesthetic result, i.e. little or no residual asymmetry and minor postradiotherapy after-effects. In 20 to 25% of cases, the conservative treatment leaves lasting after-effects associated with surgery and radiotherapy. Such aesthetic after-effects are difficult to treat and they require additional plastic surgery in 5 to 10% of cases. Oncoplastic surgery, which combines large lumpectomy and remodeling procedure involving different plastic surgery methods, improves these cosmetic results after a partial mastectomy and widens the scope for conservative treatment. Today, these techniques are well codified. They range from simple reshaping to more sophisticated techniques involving a concomitant controlateral-breast-symmetrisation procedure. These surgical options must be elaborated in detail with the patient and depend on the patient, the type of the tumor, its position, the ratio between the volume of the tumor and that of the breast and the overall care given by a multispecialist team. Plastic surgery is now an integral part of the treatment of breast cancer, hence the use of the word: oncoplastic surgery.
在对乳腺癌进行保守治疗后，75%的患者最终能获得良好的美学效果，即几乎没有或完全没有残留不对称以及轻微的放疗后后遗症。在20%至25%的病例中，保守治疗会留下与手术和放疗相关的持久性后遗症。此类美学后遗症难以治疗，在5%至10%的病例中需要额外进行整形手术。肿瘤整形手术将大型肿块切除术与涉及不同整形手术方法的重塑手术相结合，改善了部分乳房切除术后的这些美容效果，并扩大了保守治疗的范围。如今，这些技术已得到很好的规范。它们从简单的重塑到涉及同期对侧乳房对称化手术的更复杂技术不等。这些手术选择必须与患者详细说明，并且取决于患者、肿瘤类型、其位置、肿瘤体积与乳房体积的比例以及多专科团队提供的整体护理。整形手术现在是乳腺癌治疗中不可或缺的一部分，因此出现了“肿瘤整形手术”这个词。
