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采用乳房下皱襞切口技术的乳腺癌保乳手术。

Breast-conserving surgery using an inframammary fold incision technique for breast cancer.

作者信息

Heiman Ullmark Jenny, Sahlin Christina, Hallberg Håkan, Olofsson Bagge Roger

机构信息

a Department of Plastic Surgery , Sahlgrenska University Hospital , Gothenburg , Sweden.

b Department of Surgery , Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital , Gothenburg , Sweden.

出版信息

J Plast Surg Hand Surg. 2017 Apr;51(2):105-111. doi: 10.1080/2000656X.2016.1194279. Epub 2016 Jun 22.

Abstract

BACKGROUND

Breast-conserving surgery is an established alternative for the majority of women with early stage breast cancer. Consensus on negative margins (no ink on tumour) for invasive cancer makes mutilating extensive lumpectomies unnecessary. Several breast-conserving surgical methods are described in the literature. The aim of this study was to describe and evaluate a technique using the inframammary fold incision.

METHODS

Twenty-seven patients with suspected breast cancer (stage I-II) underwent breast-conserving surgery using the inframammary fold incision. Data regarding tumour characteristics, margin status, complications, oncologic and aesthetic outcome was analysed retrospectively.

RESULTS

After a median follow-up of 35 months, 23 of the 24 patients with breast cancer (95.8%) had no evidence of disease. Post-operative complications (as defined by infection requiring antibiotic treatment and/or seroma requiring drainage) were seen in three of the 27 patients (11.1%). The final pathological examination revealed a positive excision margin in four patients (16.7%). Post-operative evaluation with the BREAST-Q™ BCT module showed a mean RASCH score of 72.5 regarding 'Satisfaction with breast'. The aesthetic result with a hidden scar is exemplified.

CONCLUSION

Breast-conserving surgery using the inframammary fold incision seems to be a safe method with better cosmesis; however, further research is needed.

摘要

背景

对于大多数早期乳腺癌女性患者而言,保乳手术是一种既定的替代治疗方法。对于浸润性癌,切缘阴性(肿瘤无墨染)已达成共识,使得不必要进行致残性的广泛肿块切除术。文献中描述了几种保乳手术方法。本研究的目的是描述和评估一种采用乳房下皱襞切口的技术。

方法

27例疑似乳腺癌(I-II期)患者接受了采用乳房下皱襞切口的保乳手术。对肿瘤特征、切缘状态、并发症、肿瘤学和美学结果的数据进行了回顾性分析。

结果

中位随访35个月后,24例乳腺癌患者中有23例(95.8%)无疾病证据。27例患者中有3例(11.1%)出现术后并发症(定义为需要抗生素治疗的感染和/或需要引流的血清肿)。最终病理检查显示4例患者(16.7%)切缘阳性。使用BREAST-Q™ BCT模块进行的术后评估显示,“对乳房的满意度”的平均拉施评分是72.5。展示了有隐蔽瘢痕的美学效果。

结论

采用乳房下皱襞切口的保乳手术似乎是一种安全且美容效果更好的方法;然而,仍需要进一步研究。

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