Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
J Breast Cancer. 2012 Mar;15(1):7-14. doi: 10.4048/jbc.2012.15.1.7. Epub 2012 Mar 28.
Oncoplastic breast surgery has become a popular choice of treatment for breast reconstruction after mastectomy. There are two different techniques in oncoplastic surgery depending on the volume of the excised breast tissue. One is the volume displacement procedure, which combines resection with a variety of different breast-reshaping and breast-reduction techniques; the other is the volume replacement procedure in which the volume of excised breast tissue is replaced with autologous tissue. In this study, current authors performed various volume replacement techniques based on the weight of the excised tumor and its margin of resection. We used a latissimus dorsi myocutaneous flap for cases in which the resection mass was greater than 150 g, and for cases in which the resection mass was less than 150 g, we used a regional flap, such as a lateral thoracodorsal flap, a thoracoepigastric flap, or perforator flaps, such as an intercostal artery perforator flap or a thoracodorsal artery perforator flap. In the patients with small to moderate-sized breasts, when a postoperative deformity is expected due to a large-volume tumor resection, the replacement of non-breast tissue is required. Many of whom have small breasts, oncoplastic volume replacement techniques in breast-conserving surgery allow an extensive tumor excision without concern of compromising the cosmetic outcome and can be reliable and useful techniques with satisfactory aesthetic results.
肿瘤整形乳房切除术已成为乳房切除术后乳房重建的一种流行治疗选择。根据切除的乳房组织的体积，肿瘤整形手术有两种不同的技术。一种是体积移位术，它将切除与各种不同的乳房整形和乳房缩小技术相结合；另一种是体积置换术，其中切除的乳房组织的体积用自体组织替代。在本研究中，作者根据切除肿瘤的重量及其切除边缘进行了各种体积置换技术。对于切除质量大于 150g 的病例，我们使用了背阔肌肌皮瓣；对于切除质量小于 150g 的病例，我们使用了局部皮瓣，如外侧胸背皮瓣、胸脐皮瓣或穿支皮瓣，如肋间动脉穿支皮瓣或胸背动脉穿支皮瓣。对于中小乳房的患者，如果由于大体积肿瘤切除预期会出现术后畸形，则需要替换非乳房组织。许多患者乳房较小，保乳手术中的肿瘤整形体积置换技术允许广泛切除肿瘤，而不会影响美容效果，并且可以作为可靠和有用的技术，获得满意的美容效果。
