Kelly David A, Wood Benjamin C, Knoll Gregory M, Chang Shu C, Crantford John C, Bharti Gaurav D, Levine Edward A, Thompson James T
Department of Plastic Reconstructive Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Ann Plast Surg. 2012 May;68(5):435-7. doi: 10.1097/SAP.0b013e31823b6ae3.
Breast conservation therapy (BCT) has evolved as a favorable approach to the management of early-stage breast cancer. Shortcomings of BCT include the potential need for re-excision in the event of positive tumor margins as well as the untoward sequelae of radiation therapy. Both of those factors have led to a substantial proportion of patients undergoing BCT who ultimately report suboptimal aesthetic outcomes. Application of plastic surgery principles to the management of this patient subset has been shown to be beneficial from both an oncologic and cosmetic perspective.The aim of this study was to identify factors that may predict which patients would benefit most from involvement of a plastic surgeon before BCT. A retrospective analysis was performed on 762 patients undergoing lumpectomy during a 10-year study period at a single institution. Younger women and patients with tumor size approaching 2 cm were noted to have a significantly higher likelihood of oncologic outcomes that ultimately required breast reconstruction. Integration of oncoplastic techniques in the surgical management of patients undergoing BCT would likely contribute to improvement in aesthetic outcomes and overall patient satisfaction.
保乳治疗（BCT）已发展成为早期乳腺癌治疗的一种理想方法。BCT的缺点包括肿瘤切缘阳性时可能需要再次切除以及放射治疗的不良后果。这两个因素导致相当一部分接受BCT的患者最终报告美学效果不理想。从肿瘤学和美容学角度来看，将整形手术原则应用于这部分患者的治疗已被证明是有益的。本研究的目的是确定哪些因素可以预测哪些患者在BCT前最能从整形外科医生的参与中获益。对在单一机构进行的为期10年的研究期间接受肿块切除术的762例患者进行了回顾性分析。年轻女性和肿瘤大小接近2 cm的患者最终需要乳房重建的肿瘤学结局可能性显著更高。在接受BCT患者的手术管理中整合肿瘤整形技术可能有助于改善美学效果和患者总体满意度。
