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[治疗性乳房成形术的术中、术后及长期肿瘤外科安全性]

[Intraoperative, postoperative and long-term oncosurgical safety of therapeutic mammaplasty].

作者信息

Romics László, Barrett Sophie, Stallard Sheila, Weiler-Mithoff Eva

机构信息

Victoria Infirmary Glasgow Langside Road Glasgow G49 9TY Egyesült Királyság.

出版信息

Orv Hetil. 2013 Aug 18;154(33):1291-6. doi: 10.1556/OH.2013.29660.

Abstract

INTRODUCTION

(Pre)malignant lesion in the breast requiring mastectomy conventionally may be treated with breast conservation by using oncoplastic breast surgical techniques, which is called therapeutic mammaplasty. However, no reliable data has been published so far as regards the oncological safety of this method.

AIM

The aim of the authors was to analyse the oncological safety of therapeutic mammaplasty in a series of patients.

METHOD

99 patients were treated with therapeutic mammaplasty and data were collected in a breast surgical database prospectively. Results were analysed with respect to intraoperative, postoperative and long-term oncological safety.

RESULTS

Incomplete resection rate was 14.1%, which correlated with tumour size (p = 0.023), and multifocality (p = 0.012). Time between surgery (therapeutic mammaplasty) and chemotherapy was similar to time between conventional breast surgeries (wide excision, mastectomy, mastectomy with immediate reconstruction) and chemotherapy (mean 29-31 days; p<0.05). Overall recurrence rate was 6.1%, locoregional recurrence rate was 2% during 27 month (1-88) mean follow-up.

CONCLUSIONS

Since literature data are based on relatively short follow-up and low patient number, it is highly important that all data on therapeutic mammaplasty is collected in a prospectively maintained breast surgical database in order to determine true recurrence after long-follow-up.

摘要

引言

传统上需要进行乳房切除术的乳腺(癌前)恶性病变,可采用肿瘤整形乳房手术技术进行保乳治疗,即治疗性乳房整形术。然而,就该方法的肿瘤学安全性而言,目前尚未发表可靠数据。

目的

作者旨在分析一系列患者中治疗性乳房整形术的肿瘤学安全性。

方法

对99例接受治疗性乳房整形术的患者进行前瞻性研究,并将数据收集到乳房外科数据库中。从术中、术后及长期肿瘤学安全性方面对结果进行分析。

结果

切缘阳性率为14.1%,与肿瘤大小(p = 0.023)及多灶性(p = 0.012)相关。治疗性乳房整形术与化疗之间的间隔时间,与传统乳房手术(广泛切除、乳房切除术、即刻乳房重建的乳房切除术)与化疗之间的间隔时间相似(平均29 - 31天;p<0.05)。在平均27个月(1 - 88个月)的随访期间,总复发率为6.1%,局部区域复发率为2%。

结论

由于文献数据基于相对较短的随访时间和较少的患者数量,因此至关重要的是,将所有治疗性乳房整形术的数据前瞻性地收集到乳房外科数据库中,以便确定长期随访后的真实复发情况。

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