Massa Michela, Meszaros Paolo, Baldelli Ilaria, Bisso Nadia, Franchelli Simonetta
Plastic and Reconstructive Surgery, Genoa University, Genova, Italy; Department of Surgery, Breast Unit, IRCCS AOU San Martino-IST, Genova, Italy; and Plastic and Reconstructive Surgery, IRCCS AOU San Martino-IST, Genova, Italy.
Plast Reconstr Surg Glob Open. 2015 Apr 7;3(3):e339. doi: 10.1097/GOX.0000000000000309. eCollection 2015 Mar.
In conservative breast surgery, the achievement of a satisfactory cosmetic result could be challenging; oncoplastic techniques may be helpful in many cases. A comparative analysis was performed among 3 groups of patients undergoing oncoplastic techniques plus external radiation therapy or intraoperative radiotherapy (IORT) and breast conservative surgery plus external radiation therapy; long-term oncologic results in terms of disease relapse and aesthetic outcomes were compared.
Ninety-six patients were considered: 32 patients treated with oncoplastic surgery, 16 then subjected to radiotherapy (group 1) and another 16 treated with IORT (group 2); 64 patients treated by conservative surgery and radiotherapy formed the control group (group 3). Patients were asked to give a judgment on the cosmetic result considering the following parameters: breast symmetry, appearance of the residual scar, symmetry between the 2 nipple-areola complexes, global aesthetic judgment, and satisfaction about the result.
With respect to the oncological and aesthetic outcome, the statistical significance of the results obtained in the 3 groups was calculated using the chi-square test. The results, processed by the chi-square test, were not statistically significant; however, the overall judgments expressed by the patients of all 3 groups were more than satisfactory (scores greater than or equal to 6).
In our experience, when the inclusion criteria are satisfied and the equipment is available, oncoplastic techniques associated with IORT should be considered the treatment of choice for breast cancer in early stage. The excellent cosmetic results and patient's satisfaction encourage us to continue on this way.
在保乳手术中，要获得满意的美容效果可能具有挑战性；整形技术在许多情况下可能会有所帮助。对三组接受整形技术加外照射放疗或术中放疗（IORT）以及保乳手术加外照射放疗的患者进行了比较分析；比较了疾病复发方面的长期肿瘤学结果和美学效果。
纳入96例患者：32例行整形手术，其中16例随后接受放疗（第1组），另外16例接受IORT（第2组）；64例接受保乳手术和放疗的患者作为对照组（第3组）。要求患者根据以下参数对美容效果进行评价：乳房对称性、残余瘢痕外观、双侧乳头乳晕复合体之间的对称性、整体美学评价以及对结果的满意度。
关于肿瘤学和美学结果，使用卡方检验计算三组所得结果的统计学意义。经卡方检验处理的结果无统计学意义；然而，所有三组患者的总体评价均超过满意程度（评分大于或等于6）。
根据我们的经验，当满足纳入标准且设备可用时，与IORT相关的整形技术应被视为早期乳腺癌的首选治疗方法。出色的美容效果和患者满意度鼓励我们继续采用这种方法。
