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肿瘤整形保乳手术在亚洲乳腺癌患者中的适用性

Applicability of Oncoplastic Breast Conserving Surgery in Asian Breast Cancer Patients.

作者信息

Lim GeokHoon, Pineda Lea Angela

机构信息

Department of Breast Surgery, KK Women's and Children's Hospital, Bukit Timah Road, Singapore Email :

出版信息

Asian Pac J Cancer Prev. 2016;17(7):3325-8.

PMID:27509971
Abstract

BACKGROUND

There are limited studies on oncoplastic breast conserving surgery in Asian women. We aimed to determine the applicability and safety of oncoplastic surgery, highlighting the specific circumstances when it will be most useful and compare our preferred technique with the worldwide practice of oncoplastic approaches.

MATERIALS AND METHODS

Breast cancer patients who underwent oncoplastic breast conserving surgery at a single institution from 1st May 201431st March 2015 were included. Data on patient demographics, tumor characteristics and the type of oncoplastic surgery performed were collected.

RESULTS

Nineteen breast cancer patients were identified. 42.1% of patients had grade I ptosis. The indications for surgery included a large tumor to breast size ratio (52.6%), multifocal/multicentric lesions (36.8%) and asymmetric breasts (10.6%), averting a mastectomy in 89.4%. Round block was the commonest technique in 63% of patients, in contrast to the inverted T pattern most frequently used in renowned institutions in the West. Mean and median tumor size and weight of specimen were 29.4/25mm (11 75mm) and 77g/64g (10 246g) respectively. Reexcision rate was 10.5%. Complete mastectomy was performed for one patient. One patient developed wound dehiscence which was treated conservatively. Cosmetic outcome was rated as excellent/good by 94.7% of patients. The patients remained clinically well after a median 16 months follow up.

CONCLUSIONS

Oncoplastic breast conserving surgery is useful in a specific subgroup of Asian patients with a relatively small breast volume and minimal ptosis. Round block was the commonest technique in our series, in contrast to the worldwide utility of oncoplastic techniques. It is oncologically safe and has good cosmetic outcomes.

摘要

背景

关于亚洲女性肿瘤整形保乳手术的研究有限。我们旨在确定肿瘤整形手术的适用性和安全性,强调其最有用的具体情况,并将我们首选的技术与全球肿瘤整形方法的实践进行比较。

材料与方法

纳入2014年5月1日至2015年3月31日在单一机构接受肿瘤整形保乳手术的乳腺癌患者。收集患者人口统计学数据、肿瘤特征及所施行的肿瘤整形手术类型。

结果

确定了19例乳腺癌患者。42.1%的患者有I级上睑下垂。手术适应证包括肿瘤与乳房大小比例大(52.6%)、多灶/多中心病变(36.8%)和乳房不对称(10.6%),89.4%的患者避免了乳房切除术。63%的患者最常用圆形切除法,而西方著名机构最常用的是倒T形法。标本的平均和中位肿瘤大小及重量分别为29.4/25mm(11~75mm)和77g/64g(10~246g)。再次切除率为10.5%。1例患者接受了全乳房切除术。1例患者发生伤口裂开,经保守治疗。94.7%的患者对美容效果评为优秀/良好。中位随访16个月后患者临床情况良好。

结论

肿瘤整形保乳手术对乳房体积相对较小且上睑下垂程度较轻的特定亚洲患者亚组有用。在我们的系列研究中,圆形切除法是最常用的技术,这与全球肿瘤整形技术的应用情况不同。它在肿瘤学上是安全的,并且有良好的美容效果。

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