Vogel Jeffery E, Chu Carrie, McCullough Meghan, Anderson Erica, Losken Albert, Carlson Grant W
Division of Plastic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Ann Plast Surg. 2011 May;66(5):557-60. doi: 10.1097/SAP.0b013e318216b648.
Breast cancer in women under 40 years of age is rare, accounting for approximately 5% of cases. The disease tends to be more aggressive in younger women. Younger age has been shown to be an independent predictive of breast reconstruction after total mastectomy. Treatment by total mastectomy and reconstruction is examined in relation to patient age.
A retrospective review of all breast cancer patients treated by total mastectomy and reconstruction between 2005 and 2009 was performed by querying a prospective database.
A total of 671 patients underwent total mastectomy and reconstruction; of them, 106 (16%) aged <40 and 565 (84%) aged ≥40 years. Compared with older patients, the age <40 group was more likely to present with advanced breast cancer (P < 0.001), receive radiation (P = 0.006), undergo contralateral prophylactic mastectomy (P < 0.001) and bilateral reconstruction (P = 0.005), and undergo delayed reconstruction (P = 0.02). Transverse rectus abdominis musculocutaneous flap reconstruction was more common in the age ≥40 years (P = 0.03). Bilateral reconstruction was most commonly performed with tissue expansion regardless of patient age.
Breast reconstruction in women less than 40 years of age is influenced by advanced tumor stage and the necessity for adjuvant radiation therapy as well as an increased use of contralateral prophylactic mastectomy.
40岁以下女性患乳腺癌较为罕见，约占病例总数的5%。该疾病在年轻女性中往往更具侵袭性。年龄较小已被证明是全乳切除术后乳房重建的一个独立预测因素。本文针对患者年龄，研究了全乳切除及重建治疗方法。
通过查询前瞻性数据库，对2005年至2009年间接受全乳切除及重建治疗的所有乳腺癌患者进行回顾性分析。
共有671例患者接受了全乳切除及重建手术；其中，106例（16%）年龄小于40岁，565例（84%）年龄大于或等于40岁。与老年患者相比，年龄小于40岁的组更易出现晚期乳腺癌（P < 0.001），接受放疗（P = 0.006），进行对侧预防性乳房切除术（P < 0.001）和双侧重建（P = 0.005），以及进行延迟重建（P = 0.02）。腹直肌肌皮瓣重建在年龄大于或等于40岁的患者中更为常见（P = 0.03）。无论患者年龄如何，双侧重建最常采用组织扩张术。
年龄小于40岁女性的乳房重建受肿瘤晚期阶段、辅助放疗的必要性以及对侧预防性乳房切除术使用增加的影响。
