Kim Hye Ri, Lim Jin Soo, Kim Sue Min, Jung Sung No, Yoo Gyeol, Rha Eun Young
Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
Arch Plast Surg. 2013 Sep;40(5):553-8. doi: 10.5999/aps.2013.40.5.553. Epub 2013 Sep 13.
Skin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM) has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM.
Among the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview.
During the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur.
Since one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.
保留皮肤的乳房切除术联合即刻乳房重建日益成为早期乳腺癌患者经证实的手术选择。保留乳晕的乳房切除术（ASM）近来也成为一种流行的术式。本文旨在探讨采用ASM进行一期乳头和乳房重建时所遇到的重建及美学问题。
在2008年3月至2010年3月期间接受乳房切除术的患者中，5例乳头乳晕复合体恶性受累可能性低的女性接受了ASM及即刻乳房重建，并采用改良C-V瓣同时进行乳头重建。该系列的美容效果由整形外科医生进行评估，并通过电话访谈对患者的自我评估及满意度进行评估。
在平均11个月的随访期内，无癌症复发病例，美学效果评定为优秀至非常好，所有患者均满意。2例患者在重建乳头周围出现沟状凹陷，1例患者乳晕小面积出现皮肤糜烂，经保守换药愈合。未发生其他并发症，如皮瓣或乳晕坏死、血清肿、血肿或脂肪坏死。
由于ASM术后一期乳头和乳房重建在肿瘤学上是安全的、具有成本效益且美学效果令人满意，因此它是早期乳腺癌患者的一种良好手术选择。
