Department of Surgical Oncology, Breast and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Surg Today. 2011 Apr;41(4):477-89. doi: 10.1007/s00595-010-4307-z. Epub 2011 Mar 23.
Although breast-conserving therapy (BCT) is the standard form of treatment for early-stage breast cancer, in patients with small breasts cosmetic results can be poor, especially when the lesion is located on the inner upper quadrant area. This study analyzes our use of autologous free dermal fat grafts (FDFGs) for immediate breast reconstruction.
A total of 23 patients who received a partial mastectomy for an inner upper quadrant lesion from 1992 to 2006 at Kagoshima University Hospital were retrospectively divided into three groups according to the reconstructive procedure that was used for the defect after partial mastectomy: immediate reconstruction using an autologous FDFG from the lower abdomen (group FDFG); patients receiving only rotation and fixation of the parenchymal adipose tissue or gland to repair the defect (group GL); and a third group who underwent immediate reconstruction using a miniflap of the latissimus dorsi (group LD).
The total duration of surgery in group FDFG was significantly shorter than in group LD (P < 0.01). The mean volume of blood lost in group FDFG was significantly lower than in group LD (P < 0.01). The breast retraction assessment (BRA) of group FDFG was significantly better than for the patients in groups GL and LD (P < 0.01). The total score using the ABNSW system for cosmetic assessment was significantly better in group FDFG than in group GL (P < 0.01). Similarly, the total score in group FDFG using the assessment by the Japanese Breast Cancer Society was significantly higher than that in group GL (P < 0.01).
Immediate breast reconstruction for a defect after a partial mastectomy of an upper inner quadrant malignant lesion using FDFG can be especially useful for patients with small breasts.
虽然保乳治疗（BCT）是早期乳腺癌的标准治疗形式，但对于乳房较小的患者，美容效果可能较差，尤其是当病变位于内上象限区域时。本研究分析了我们使用自体游离真皮脂肪移植（FDFG）进行即刻乳房重建的情况。
回顾性分析 1992 年至 2006 年在鹿儿岛大学医院接受内上象限病变部分乳房切除术的 23 例患者，根据部分乳房切除术后缺损的重建方法将其分为三组：下腹部自体 FDFG 即刻重建组（FDFG 组）；仅进行实质脂肪组织或腺体旋转和固定以修复缺损的患者（GL 组）；即刻使用背阔肌小皮瓣重建的第三组（LD 组）。
FDFG 组的手术总时间明显短于 LD 组（P < 0.01）。FDFG 组的平均失血量明显低于 LD 组（P < 0.01）。FDFG 组的乳房回缩评估（BRA）明显优于 GL 组和 LD 组（P < 0.01）。FDFG 组的 ABNSW 系统美容评估总评分明显优于 GL 组（P < 0.01）。同样，FDFG 组使用日本乳腺癌协会评估的总评分也明显高于 GL 组（P < 0.01）。
对于内上象限恶性病变部分乳房切除术后缺损，使用 FDFG 即刻乳房重建对于乳房较小的患者尤其有用。
