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自体脂肪注射隆乳后簇状微钙化的临床分析。

Clinical analyses of clustered microcalcifications after autologous fat injection for breast augmentation.

机构信息

Beijing, People's Republic of China From the Department of Plastic Surgery, Meitan General Hospital, and the Department of Plastic Surgery, Peking Union Medical College Hospital.

出版信息

Plast Reconstr Surg. 2011 Apr;127(4):1669-1673. doi: 10.1097/PRS.0b013e318208d1e4.

Abstract

BACKGROUND

Autologous fat injection for breast augmentation has been disputed with regard to its complications for many years, especially regarding calcifications, most of which present with benign features. In previous studies, clustered microcalcifications were not observed after fat injection for breast augmentation, which are usually regarded as malignant calcifications.

METHODS

From July of 1999 to December of 2009, autologous fat injection for breast augmentation was performed for both breasts in 48 patients. Eight patients with clustered microcalcifications found by mammography after surgery were analyzed retrospectively. For the nonpalpable breast lesions in three patients, the clustered microcalcifications were resected with the help of needle localized breast biopsy. The palpable lump, including clustered microcalcifications, was resected 1 cm away from its border in the other patients. All of the specimens were submitted to pathologic examination.

RESULTS

The digitized mammographic films of eight of 48 patients (16.7 percent) showed clustered microcalcifications after autologous fat injection, which were highly suspected of being breast carcinoma microcalcifications, whereas all pathologic examinations indicated fat necroses.

CONCLUSIONS

Clustered microcalcifications can be found after autologous fat injection for breast augmentation, which cannot be distinguished from malignancy. The mammographic confusion constitutes the problem rather than the success of the procedure itself, and the method should continue to be prohibited.

摘要

背景

自体脂肪注射隆乳术多年来一直存在并发症争议,尤其是钙化问题,其中大部分表现为良性特征。在以前的研究中,没有观察到脂肪注射隆乳术后出现簇状微钙化,这些钙化通常被认为是恶性钙化。

方法

1999 年 7 月至 2009 年 12 月,48 例患者接受了双侧自体脂肪注射隆乳术。对术后乳腺 X 线摄影检查发现的 8 例簇状微钙化患者进行回顾性分析。对于 3 例触诊阴性的乳腺病变,在针吸定位活检的帮助下切除簇状微钙化灶。对于其他患者,切除触及的肿块及其周围 1cm 范围内的簇状微钙化灶。所有标本均进行病理检查。

结果

48 例患者中有 8 例(16.7%)数字化乳腺 X 线摄影显示自体脂肪注射隆乳术后出现簇状微钙化,高度怀疑为乳腺癌微钙化,但所有病理检查均提示为脂肪坏死。

结论

自体脂肪注射隆乳术后可出现簇状微钙化,与恶性肿瘤难以区分。乳腺 X 线摄影的混淆构成了问题,而不是手术本身的成功,因此该方法应继续被禁止。

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