Brown Jennifer R, Holton Luther H, Chung Thomas L, Slezak Sheri
Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, USA.
Ann Plast Surg. 2008 Oct;61(4):375-9. doi: 10.1097/SAP.0b013e318160223f.
The current indications for reduction mammoplasty include the relief of painful physical symptoms of macromastia. Numerous studies have demonstrated not only improvement in physical symptoms following reduction mammoplasty, but postoperative psychological benefits as well, including increased ability to participate in physical activity as a result of pain relief and decreased breast mass. Reduction mammoplasty may have additional effects on the patient's ability to breast-feed and perform breast self-exam. The present study is a retrospective study of the effects of reduction mammoplasty on breast-feeding, breast self-exam, physical symptoms, and physical activity. One-hundred and forty-one patients who underwent reduction mammoplasty at our institution between the years 1996-2005 agreed to participate in the study. Each was asked a series of questions in order to assess changes in symptoms and behaviors including breast-feeding and breast self-exam practices before and after the surgery. Patients were also asked questions regarding their pain symptoms and physical activity profiles. Ninety-seven percent of the participants claimed to have back, neck, and/or shoulder pain that was either significantly improved or completely resolved. Moreover, 100% of patients report that physical activity such as exercise was easier following reduction mammoplasty. Ninety-three percent of participants reported that performing breast self-exam following surgery was either the same (68%) or easier (25%) as a result of having less breast tissue. Eighty-nine percent of participants had no children following surgery, therefore effects on breast-feeding practices following reduction mammoplasty were not statistically significant. However, we suggest that when patients are seen in consultation or in the perioperative period, there is an opportunity to teach patients about the benefits of breast-feeding, and to assure patients that a pedicle flap reduction will likely allow breastfeeding. This is also a chance for physicians to teach patients how to perform breast self-examination and explain the importance of early breast mass detection.
目前缩乳术的适应症包括缓解巨乳症引起的疼痛性身体症状。大量研究表明，缩乳术后不仅身体症状得到改善，术后心理状况也有益处，包括因疼痛缓解和乳房体积减小而增加了参与体育活动的能力。缩乳术可能对患者的母乳喂养能力和进行乳房自我检查的能力有额外影响。本研究是一项关于缩乳术对母乳喂养、乳房自我检查、身体症状和体育活动影响的回顾性研究。1996年至2005年间在我们机构接受缩乳术的141名患者同意参与该研究。每位患者都被问到一系列问题，以评估症状和行为的变化，包括手术前后的母乳喂养和乳房自我检查习惯。患者还被问及有关疼痛症状和体育活动情况的问题。97%的参与者称背部、颈部和/或肩部疼痛明显改善或完全缓解。此外，100%的患者报告说缩乳术后进行诸如锻炼等体育活动变得更容易。93%的参与者报告说，由于乳房组织减少，术后进行乳房自我检查与之前相同（68%）或更容易（25%）。89%的参与者术后没有孩子，因此缩乳术对母乳喂养习惯的影响无统计学意义。然而，我们建议在咨询或围手术期见到患者时，有机会向患者传授母乳喂养的益处，并向患者保证带蒂皮瓣缩乳术可能允许母乳喂养。这也是医生教导患者如何进行乳房自我检查并解释早期发现乳房肿块重要性的机会。
