Emiroglu Mustafa, Sert Ismail, Karaali Cem, Aksoy Süleyman Ozkan, Ugurlu Levent, Aydın Cengiz
Department of General Surgery, Tepecik Training and Research Hospital, Gaziler Caddesi, No: 468, Yenisehir, Izmir, Turkey.
Breast Cancer. 2016 May;23(3):463-70. doi: 10.1007/s12282-015-0585-z. Epub 2015 Jan 14.
Oncological outcomes of the oncoplastic breast surgery in patients with locally advanced breast cancer (LABC) are not well defined. This study examined the effects of oncoplastic techniques for LABC in terms of localized control and survival. We also evaluated the esthetic results of patients who had undergone oncoplastic breast conservation surgery (OBCS) and their satisfaction with the outcome.
The files and Medula (Probel Co.) database records of the patients were studied retrospectively. The esthetic evaluation was conducted by a panel. A validated satisfaction study was also performed.
In total, 42 LABC cases (median age 48 years; range 33-69 years) were included. The median observation period was 61 months (range 26-151 months). Neoadjuvant chemotherapy (NACT) was administered in 32 (76%) cases, and a pathologic complete response was observed in 7 (16.7%) cases. The median T size during the post-NACT pathological study was 27 mm (range 0-44 mm). Oncoplastic reduction surgery was performed in 13 cases, a glandular flap in 7, Grisotti flap in 5, and latissimus dorsi flap in 3 cases. The median specimen weight was 198 g (range 103-812 g), and the mean surgical margin length was 8.7 mm (range 5-17 mm). The margin was positive in 7.1% of cases, and the local repetition rate was 14.6%. The total survival rate was 86.6%, and disease-free survival was 59.6%. The rate of excellent and good ratings by the esthetic assessment panel was 79.4%. The satisfaction rate was 88.2%. The early and delayed complication rate was 16.7%.
Oncoplastic techniques are suitable and safe for patients undergoing OBCS. These techniques do not pose a risk to oncological local control. No survival or follow-up problems were detected during the 5-year follow-up period, the esthetic results were acceptable, and the satisfaction rate was high.
局部晚期乳腺癌(LABC)患者行肿瘤整形乳房手术的肿瘤学结局尚不明确。本研究从局部控制和生存方面考察了肿瘤整形技术用于LABC的效果。我们还评估了接受肿瘤整形保乳手术(OBCS)患者的美学效果及其对手术结果的满意度。
对患者的病历和Medula(Probel公司)数据库记录进行回顾性研究。由一个专家小组进行美学评估。还开展了一项经过验证的满意度研究。
共纳入42例LABC病例(中位年龄48岁;范围33 - 69岁)。中位观察期为61个月(范围26 - 151个月)。32例(76%)接受了新辅助化疗(NACT),7例(16.7%)观察到病理完全缓解。NACT后病理研究期间的中位T大小为27 mm(范围0 - 44 mm)。13例行肿瘤整形缩小手术,7例行腺体瓣手术,5例行Grisotti瓣手术,3例行背阔肌瓣手术。标本中位重量为198 g(范围103 - 812 g),平均手术切缘长度为8.7 mm(范围5 - 17 mm)。切缘阳性率为7.1%,局部复发率为14.6%。总生存率为86.6%,无病生存率为59.6%。美学评估小组的优良率为79.4%。满意度为88.2%。早期和延迟并发症发生率为16.7%。
肿瘤整形技术适用于接受OBCS的患者且安全。这些技术对肿瘤学局部控制无风险。在5年随访期内未发现生存或随访问题,美学效果可接受,满意度高。