Emiroğlu Mustafa, Sert İsmail, İnal Abdullah
Clinic of General Surgery, Tepecik Training and Research Hospital, İzmir, Turkey.
Clinic of General Surgery, Bursa Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
J Breast Health. 2015 Jan 1;11(1):1-9. doi: 10.5152/tjbh.2014.2215. eCollection 2015 Jan.
The aim of this study is to discuss indications, advantages, disadvantages, oncologic and aesthetic results of Oncoplastic Surgery (OBS). Pubmed and Medline database were searched for articles published between 1998 and 2014 for keywords: oncoplastic breast surgery, therapeutic mammoplasty, oncoplastic breast reduction, synchrenous reconstructions. Role of OBS in breast cancer surgery, its aspects to be considered, its value and results have been interpreted. This technique has advantages by providing more extensive tumourectomy, yielding better aesthetic results compared with breast conserving surgery, allowing oncoplastic reduction in breast cancer patients with macromastia, with higher patient satisfaction and quality of life and by being inexpensive due to single session practice. As for its disadvantages are: re-excision is more difficult, risk for mastectomy is higher, it is depent on the Surgeron's experience, it has a risk for delay in adjuvant therapies and its requirement for additional imaging studies during management. Main indications are patients with small tumour/breast volume, macromastia, multifocality, procedures which can disrupt breast cosmesis such as surgeries for upper inner breas tquadrient tumours. Contraindications are positive margin problems after wide excision, diffuse malign microcalsifications, inflammatory breast cancer, history of radiotherapy and patients' preferences. Despite low evidence level, Oncoplastic Breast Surgery seems to be both reliable and acceptable in terms of oncologic and aesthetic aspects. Oncoplastic Breast Surgery increase the application rate of breast conserving surgery by obviating practical limitations and improve the results of breast conserving surgery. Correct patient and technique choice in OBS is vital for optimization of post surgical.
本研究旨在探讨肿瘤整形手术（OBS）的适应证、优点、缺点、肿瘤学及美学效果。通过在Pubmed和Medline数据库中检索1998年至2014年间发表的文章，关键词为：肿瘤整形乳房手术、治疗性乳房成形术、肿瘤整形乳房缩小术、同期重建术。对OBS在乳腺癌手术中的作用、需考虑的方面、价值及结果进行了解读。该技术具有以下优点：能进行更广泛的肿瘤切除，与保乳手术相比美学效果更佳，可对巨乳症乳腺癌患者进行肿瘤整形缩小，患者满意度和生活质量更高，且因单次手术操作费用低廉。其缺点包括：再次切除更困难，乳房切除术风险更高，依赖外科医生经验，辅助治疗有延迟风险，且在治疗过程中需要额外的影像学检查。主要适应证为肿瘤/乳房体积小、巨乳症、多灶性、可能破坏乳房美容效果的手术（如乳房上内侧象限肿瘤手术）患者。禁忌证为广泛切除后切缘阳性问题、弥漫性恶性微钙化、炎性乳腺癌、放疗史及患者偏好。尽管证据水平较低，但肿瘤整形乳房手术在肿瘤学和美学方面似乎既可靠又可接受。肿瘤整形乳房手术通过消除实际限制提高了保乳手术的应用率，并改善了保乳手术的效果。在OBS中正确选择患者和技术对于优化术后效果至关重要。
