Adimulam G, Challa V R, Dhar A, Chumber S, Seenu V, Srivastava A
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Indian J Cancer. 2014 Jan-Mar;51(1):58-62. doi: 10.4103/0019-509X.134629.
The aim of this study was to assess the cosmetic outcome of patients undergoing oncoplastic breast conserving surgery in Indian population.
A prospective cohort of 35 patients who were eligible for breast conservation surgery was included in the study from year 2007 to 2009. Patients with central quadrant tumors were excluded from the study. A double - blind cosmetic assessment was done by a plastic surgeon and a senior nurse not involved in the management of patients. Moreover, self-assessment was carried out by the patient regarding the satisfaction of surgery, comfort with brasserie, social and sexual life after oncoplastic surgery.
In this study, 35 patients underwent oncoplastic breast conservation surgery by various techniques. The cosmetic outcome scores of the surgeon and nurse were analyzed for inter rater agreement using inter-class Correlation Coefficients. There was a good association between them. The risk factors for poor cosmetic outcome was studied by univariate analysis and significant correlation was obtained with age, volume of breast tissue excised and estimated percentage of breast volume excised (P < 0.05). Moreover, 96% of patients were moderately to extremely satisfied with the surgery. Patients were offered an option for cosmetic correction of contralateral breast by mastopexy or reduction mammoplasty however, none of them agreed for another procedure.
Oncoplastic breast surgery helps to resect larger volume of tissue with wider margins around the tumor. It helps to achieve better cosmesis and extends the indications for breast conservation. Most of the patients were satisfied with mere preservation of the breast mound rather than a symmetrical contralateral breast.
本研究旨在评估印度人群中接受肿瘤整形保乳手术患者的美容效果。
2007年至2009年纳入了35例符合保乳手术条件的前瞻性队列研究患者。中央象限肿瘤患者被排除在研究之外。由一名整形外科医生和一名未参与患者管理的资深护士进行双盲美容评估。此外，患者就手术满意度、胸罩舒适度、肿瘤整形手术后的社交和性生活进行了自我评估。
本研究中，35例患者采用多种技术进行了肿瘤整形保乳手术。使用组内相关系数分析外科医生和护士的美容效果评分以评估评分者间的一致性。他们之间存在良好的相关性。通过单因素分析研究了美容效果差的危险因素，并与年龄、切除的乳腺组织体积和估计切除的乳腺体积百分比获得了显著相关性（P<0.05）。此外，96%的患者对手术中度至极度满意。患者可选择通过乳房上提术或乳房缩小成形术对侧乳房进行美容矫正，但他们均未同意进行另一项手术。
肿瘤整形乳房手术有助于切除更大体积的组织，肿瘤周围有更宽的切缘。它有助于实现更好的美容效果并扩大保乳的适应证。大多数患者对仅保留乳房而不是对称的对侧乳房感到满意。
