Department of Plastic and Reconstructive Surgery, Hospital Universitario Ramón y Cajal, Carretera Colmenar Viejo KM 9,100, 28049 Madrid, Spain.
Breast Cancer Res Treat. 2010 Sep;123 Suppl 1:67-74. doi: 10.1007/s10549-010-1127-1. Epub 2010 Aug 19.
Recovery of body image after mastectomy is essential for physical and mental quality of life. Partial or total mastectomy deformities can be reversed by reconstructive surgical procedures. Young women with breast cancer have specific characteristics related to the age of onset of the disease, prognosis and reconstructive expectations. Patient individualization is the key to a successful breast reconstruction. Autologous and prosthetic reconstruction are the two main techniques used for breast reconstruction. Each reconstructive technique has its own indications, advantages and limitations. Timing of the surgery is primarily determined by the requirement for adjuvant radiotherapy, so an immediate or a delayed approach can be recommended. In patients in whom the need for adjuvant radiotherapy is in doubt, a delayed-immediate approach is the best to optimize aesthetic and oncologic outcomes. Prophylactic mastectomy is also being indicated in a growing number of patients. In these patients it is important to choose a similar reconstructive procedure on both sides to achieve breast symmetry.
乳房切除术后的身体意象恢复对于身心健康质量至关重要。部分或全部乳房切除术畸形可以通过重建手术来逆转。年轻的乳腺癌患者具有与疾病发病年龄、预后和重建期望相关的特定特征。患者个体化是成功乳房重建的关键。自体和假体重建是用于乳房重建的两种主要技术。每种重建技术都有其自身的适应证、优点和局限性。手术时机主要取决于辅助放疗的需求,因此可以推荐即刻或延迟方法。对于辅助放疗需求不确定的患者,延迟-即刻方法是优化美学和肿瘤学结果的最佳方法。越来越多的患者也被建议进行预防性乳房切除术。在这些患者中,重要的是在两侧选择相似的重建手术,以实现乳房对称。