Lapid Oren, Noels Eline C, Meijer Sybren L
Dr Lapid is a plastic surgeon and Dr Noels was a medical student in the Department of Plastic, Reconstructive and Hand Surgery
Dr Lapid is a plastic surgeon and Dr Noels was a medical student in the Department of Plastic, Reconstructive and Hand Surgery.
Aesthet Surg J. 2014 Jul;34(5):714-8. doi: 10.1177/1090820X14531144. Epub 2014 Jul 1.
After breast augmentation, additional operations are often needed for revision or explantation. Although the surgeon may elect to leave the capsule in situ during these procedures, excised capsule tissue may be examined histopathologically for cancer cells.
The authors assessed pathologic findings from breast implant capsules submitted for histopathologic examination and evaluated whether it is oncologically safe to leave capsule tissue in situ.
The authors searched PALGA, the nationwide histopathology and cytopathology data network and registry in the Netherlands, for primary capsulectomy specimens excised between 2003 and 2012. The authors applied a sensitive search strategy with low specificity that included female and breast as the sex and anatomic location keywords, and wildcards were used to detect different spellings. Cases were excluded if previous examinations showed compatibility with a history of breast cancer, prophylactic mastectomy, or prophylactic oophorectomy. The pathologic reports were manually reviewed for relevance, and each case's diagnosis was registered. A total of 6803 reports were available, representing 4948 patients; 2574 reports from 2531 patients were included in this study. The median age of patients was 51.2 ± 12.0 years (range, 15-88 years).
Invasive carcinoma was detected in 4 patients (0.16%). Four patients (0.16%) had ductal carcinoma in situ, and 1 patient (0.04%) had lobular carcinoma in situ. Metaplasia was noted in 51 patients (2.0%), calcifications in 375 (14.6%), and silicone in 701 (27.2%).
The incidence of occult invasive or in situ carcinoma in capsulectomy specimens of patients with no previous breast pathology is low. Therefore, it appears oncologically safe to leave capsule tissue in situ.
隆胸术后，通常需要进行额外的手术来修复或取出植入物。尽管外科医生在这些手术过程中可能选择保留包膜，但切除的包膜组织可进行组织病理学检查以查找癌细胞。
作者评估了提交进行组织病理学检查的乳房植入物包膜的病理结果，并评估了保留包膜组织在肿瘤学上是否安全。
作者在荷兰全国性的组织病理学和细胞病理学数据网络及登记处PALGA中，搜索了2003年至2012年间切除的原发性包膜切除术标本。作者采用了一种敏感性高但特异性低的搜索策略，将女性和乳房作为性别和解剖部位关键词，并使用通配符来检测不同的拼写。如果先前的检查显示与乳腺癌、预防性乳房切除术或预防性卵巢切除术病史相符，则排除这些病例。人工审查病理报告的相关性，并记录每个病例的诊断。共有6803份报告，代表4948例患者；本研究纳入了来自2531例患者的2574份报告。患者的中位年龄为51.2±12.0岁（范围为15 - 88岁）。
4例患者（0.16%）检测到浸润性癌。4例患者（0.16%）有导管原位癌，1例患者（0.04%）有小叶原位癌。51例患者（2.0%）出现化生，375例（14.6%）出现钙化，701例（27.2%）出现硅酮。
既往无乳腺病理病史的患者，其包膜切除术标本中隐匿性浸润性癌或原位癌的发生率较低。因此，保留包膜组织在肿瘤学上似乎是安全的。
3级
