Mazouni C, Pachet C, Rimareix F
Service de sénologie et de chirurgie reconstructrice mammaire, département de chirurgie générale, institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94800 Villejuif, France.
Gynecol Obstet Fertil. 2009 Sep;37(9):742-8. doi: 10.1016/j.gyobfe.2009.06.005. Epub 2009 Aug 13.
Achieving a mastectomy occurs in one third of the acts of breast cancer surgery. In the present context, the increase in the diagnosis of early breast cancer, including widespread or multifocal forms, the possibility of a reconstruction at the same time is discussed. It will be proposed in a specific context, taking into account various factors: oncological (characteristics of the tumor, adjuvant treatments), clinical (smoking, comorbidity) and psychological (choice of the patient). The technique of mastectomy will be adapted to the indication and choice of reconstruction procedure. Including the preservation of the nipple-areola complex, or the skin envelope will be possible for some guidance. The reconstruction is possible with the use of breast implants, or musculocutaneous flaps or by the combination of both. Some of these techniques are associated with significant morbidity, and appropriate selection of procedure to the patient will guarantee a lower risk of complications.
乳房切除术占乳腺癌手术的三分之一。在当前情况下，早期乳腺癌（包括广泛或多灶性形式）的诊断有所增加，同时也在讨论同期进行乳房重建的可能性。将在特定背景下提出建议，考虑各种因素：肿瘤学因素（肿瘤特征、辅助治疗）、临床因素（吸烟、合并症）和心理因素（患者的选择）。乳房切除术技术将根据重建手术的指征和选择进行调整。包括保留乳头乳晕复合体，或在某些指导下保留皮肤包膜。使用乳房植入物、肌皮瓣或两者结合都可以进行重建。其中一些技术会带来较高的发病率，为患者适当选择手术将保证较低的并发症风险。
