Liu Jun, Lin Jie, Hao Ya-ting, Yang Yan-fang, Fang Zhi-yi, Gu Lin
Tianjin Medical University, Tianjin, China.
Zhonghua Yi Xue Za Zhi. 2012 Dec 25;92(48):3420-2.
To evaluate the cosmetic outcomes of applying pedicle fat flap below breast fold for repairing inferior quadrant defect in breast-conserving surgery.
From May 2009 to July 2011, 18 cases of breast cancer at our hospital were recruited. All cases underwent breast-conserving procedures and achieved negative margin by frozen section examination. Then pedicle fat flap below breast fold was applied to reshape breast defect. All of them were of females with a median age of 43 years (range: 33 - 59). The median tumor size was 2.5 cm (range: 2.0 - 3.0). All tumors were located at the inferior quadrant of breast. All of them received whole breast radiotherapy and adjuvant chemotherapy. And 10 cases with positive estrogen receptor had adjuvant endocrine therapy. They were followed up at one-month postoperatively. Upon the completion of chemotherapy and radiotherapy, then follow-up was once every 4 months. The cosmetic outcomes and disease relapse were observed.
All pedicle fat flaps survived without necrosis. After a median follow-up period of 15 months, all survived disease-free. Fat liquefaction was observed in 2 cases. The whole breast radiotherapy had no significant effect on pedicle fat flap. The rate of good cosmetics was 88.9%. And their subjective satisfactory rate was 100.0%.
Both satisfactory aesthetic outcome and good efficacy are obtained with pedicle fat flap below breast fold for tumors located at the inferior quadrant of breast.
评估应用乳房皱襞下带蒂脂肪瓣修复保乳手术中下象限缺损的美容效果。
选取2009年5月至2011年7月我院收治的18例乳腺癌患者。所有病例均接受保乳手术，术中冰冻切片检查切缘阴性。然后应用乳房皱襞下带蒂脂肪瓣修复乳房缺损。所有患者均为女性，中位年龄43岁（范围：33 - 59岁）。肿瘤中位大小为2.5 cm（范围：2.0 - 3.0 cm）。所有肿瘤均位于乳房下象限。所有患者均接受全乳放疗及辅助化疗。10例雌激素受体阳性患者接受辅助内分泌治疗。术后1个月进行随访。放化疗结束后，每4个月随访1次。观察美容效果及疾病复发情况。
所有带蒂脂肪瓣均存活，无坏死。中位随访15个月后，所有患者均无病存活。2例出现脂肪液化。全乳放疗对带蒂脂肪瓣无明显影响。美容效果良好率为88.9%。主观满意率为100.0%。
对于位于乳房下象限的肿瘤，应用乳房皱襞下带蒂脂肪瓣可获得满意的美学效果和良好的疗效。
