Holmes Dennis R, Schooler Wesley, Smith Robina
Kenneth Norris Comprehensive Cancer Center and Division of Surgical Oncology, Keck School of Medicine, University of Southern California, 1441 Topping Tower, Suite 7415, Los Angeles, CA 90033, USA.
Int J Breast Cancer. 2011;2011:303879. doi: 10.4061/2011/303879. Epub 2011 Aug 22.
When a woman is diagnosed with breast cancer many aspects of her physical, emotional, and sexual wholeness are threatened. The quickly expanding field of oncoplastic breast surgery aims to enhance the physician commitment to restore the patient's image and self-assurance. By combining a multidisciplinary approach to diagnosis and treatment with oncoplastic surgery, successful results in the eyes of the patient and physician are significantly more likely to occur. As a way to aid oncoplastic teams in determining which approach is most suitable for their patient's tumor size, tumor location, body habitus, and desired cosmetic outcome we present a review of several oncoplastic surgical approaches. For resections located anywhere in the breast, the radial ellipse segmentectomy incision and circumareolar approach for segmental resection are discussed. For resections in the upper or central breast, crescent mastopexy, the batwing incision, the hemibatwing incision, donut mastopexy, B-flap resection, and the central quadrantectomy are reviewed. For lesions of the lower breast, the triangle incision, inframammary incision, and reduction mastopexy are discussed. Surgeons who are interested in adding oncoplastic breast conserving therapies to their skill sets are encouraged to implement these surgical techniques where applicable and to seek out breast fellowships or enhanced training when appropriate.
当一名女性被诊断出患有乳腺癌时,她身体、情感和性方面的完整性会受到多方面的威胁。快速发展的肿瘤整形乳房手术领域旨在增强医生致力于恢复患者形象和自信的决心。通过将多学科的诊断和治疗方法与肿瘤整形手术相结合,在患者和医生眼中更有可能取得成功的结果。作为一种帮助肿瘤整形团队确定哪种方法最适合其患者的肿瘤大小、肿瘤位置、身体形态和期望的美容效果的方式,我们对几种肿瘤整形手术方法进行了综述。对于乳房任何部位的切除,讨论了放射状椭圆形节段切除术切口和节段性切除的乳晕周围入路。对于乳房上部或中央部分的切除,回顾了新月形乳房固定术、蝙蝠翼切口、半蝙蝠翼切口、甜甜圈乳房固定术、B瓣切除术和中央象限切除术。对于乳房下部的病变,讨论了三角形切口、乳房下切口和缩小乳房固定术。鼓励有兴趣将肿瘤整形保乳治疗纳入其技能范围的外科医生在适用时采用这些手术技术,并在适当的时候寻求乳房专科进修或强化培训。