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肿瘤-乳头距离小于2.0厘米的乳腺癌患者行保留乳头的乳房切除术并即刻乳房重建的可行性

Feasibility of Nipple-Sparing Mastectomy with Immediate Breast Reconstruction in Breast Cancer Patients with Tumor-Nipple Distance Less Than 2.0 cm.

作者信息

Ryu Jai Min, Nam Seok Jin, Kim Seok Won, Lee Se Kyung, Bae Soo Youn, Yi Ha Woo, Park Sungmin, Paik Hyun-June, Lee Jeong Eon

机构信息

Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center Cancer Hospital, School of Medicine, Sungkyunkwan University, 5th Floor, Irwon-ro 81, Gangnam-gu, Seoul, 135-710, Korea.

出版信息

World J Surg. 2016 Aug;40(8):2028-35. doi: 10.1007/s00268-016-3487-0.

Abstract

BACKGROUND AND OBJECTIVE

Debate continues concerning the oncological risk of nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) if the tumor-nipple distance (TND) is less than 2.0 cm. In this retrospective study, we analyzed oncological outcomes after NSM with IBR for the treatment of breast cancer to determine the risk posed by NSM in cases in which magnetic resonance imaging (MRI) showed a TND <2.0 cm but intraoperative frozen biopsy results were negative for tumor cells at the nipple base.

MATERIALS AND METHODS

We conducted a retrospective review of patients with breast cancer who underwent NSM with IBR at Samsung Medical Center between 2008 and 2014. Preoperative MRI was done in all cases to define the TND, and frozen biopsy specimens were obtained intraoperatively.

RESULTS

Among the 266 NSMs performed, TND was <2.0 cm in 145 cases (54.5 %) and ≥2.0 cm in 121 cases (45.5 %). Median follow-up was 25.6 months. There were no significant differences between the two patient groups with respect to disease-free survival or local recurrence-free survival.

CONCLUSION

Our results suggest that NSM can be a feasible treatment option when the intraoperative frozen biopsy is negative for tumor cells even with a TND <2.0 cm in MRI.

摘要

背景与目的

对于肿瘤乳头距离(TND)小于2.0厘米的保乳根治术(NSM)联合即刻乳房重建术(IBR)的肿瘤学风险,目前仍存在争议。在这项回顾性研究中,我们分析了NSM联合IBR治疗乳腺癌后的肿瘤学结局,以确定在磁共振成像(MRI)显示TND<2.0厘米但术中冰冻活检结果显示乳头基底肿瘤细胞为阴性的情况下,NSM所带来的风险。

材料与方法

我们对2008年至2014年期间在三星医疗中心接受NSM联合IBR的乳腺癌患者进行了回顾性研究。所有病例均进行了术前MRI以确定TND,并在术中获取了冰冻活检标本。

结果

在进行的266例NSM中,145例(54.5%)的TND<2.0厘米,121例(45.5%)的TND≥2.0厘米。中位随访时间为25.6个月。两组患者在无病生存率或无局部复发生存率方面无显著差异。

结论

我们的结果表明,即使MRI显示TND<2.0厘米,但术中冰冻活检肿瘤细胞为阴性时,NSM可能是一种可行的治疗选择。

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