St. Joseph Hospital, The Center for Cancer Treatment and Prevention, Orange, CA, USA.
Ann Surg Oncol. 2011 Apr;18(4):917-22. doi: 10.1245/s10434-010-1365-9. Epub 2010 Oct 7.
The use of areola-sparing (AS) or nipple-areola-sparing (NAS) mastectomy for the treatment or risk reduction of breast cancer has been the subject of increasing dialogue in the surgical literature over the past decade. We report the initial experience of a large community hospital with AS and NAS mastectomies for both breast cancer treatment and risk reduction.
A retrospective chart review was performed of patients undergoing either AS or NAS mastectomies from November 2004 through September 2009. Data collected included patient sex, age, family history, cancer type and stage, operative surgical details, complications, adjuvant therapies, and follow-up.
Forty-three patients underwent 60 AS and NAS mastectomies. Forty-two patients were female and one was male. The average age was 48.7 years (range, 28-76 years). Forty mastectomies were for breast cancer treatment, and 20 were prophylactic mastectomies. The types of cancers treated were as follows: invasive ductal (n = 19), invasive lobular (n = 5), ductal carcinoma-in situ (n = 15), and malignant phyllodes (n = 1). Forty-seven mastectomies (78.3%) were performed by inframammary incisions. All patients underwent immediate reconstruction with either tissue expanders or permanent implants. There was a 5.0% incidence of full-thickness skin, areola, or nipple tissue loss. The average follow-up of the series was 18.5 months (range, 6-62 months). One patient developed Paget's disease of the areola 34 months after an AS mastectomy (recurrence rate, 2.3%). There were no other instances of local recurrence.
AS and NAS mastectomies can be safely performed in the community hospital setting with low complication rates and good short-term results.
在过去十年的外科文献中，对于乳腺癌的治疗或降低风险，乳晕保留（AS）或乳头乳晕保留（NAS）乳房切除术一直是越来越多的讨论话题。我们报告了一家大型社区医院在 AS 和 NAS 乳房切除术方面的初步经验，包括乳腺癌的治疗和降低风险。
对 2004 年 11 月至 2009 年 9 月期间行 AS 或 NAS 乳房切除术的患者进行了回顾性病历审查。收集的数据包括患者性别、年龄、家族史、癌症类型和分期、手术细节、并发症、辅助治疗和随访。
43 例患者行 60 例 AS 和 NAS 乳房切除术。42 例为女性，1 例为男性。平均年龄为 48.7 岁（范围，28-76 岁）。40 例乳房切除术用于治疗乳腺癌，20 例预防性乳房切除术。治疗的癌症类型如下：浸润性导管癌（n=19）、浸润性小叶癌（n=5）、导管原位癌（n=15）和恶性叶状肿瘤（n=1）。47 例乳房切除术（78.3%）经乳晕下切口进行。所有患者均立即行组织扩张器或永久性植入物重建。全层皮肤、乳晕或乳头组织丢失的发生率为 5.0%。该系列的平均随访时间为 18.5 个月（范围，6-62 个月）。1 例患者在 AS 乳房切除术 34 个月后发生乳晕 Paget 病（复发率为 2.3%）。无其他局部复发病例。
AS 和 NAS 乳房切除术可在社区医院安全进行，并发症发生率低，短期效果良好。
