Khan L R, Raine C R, Dixon J M
Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK.
Eur J Surg Oncol. 2017 Aug;43(8):1402-1408. doi: 10.1016/j.ejso.2017.03.014. Epub 2017 Mar 27.
The aim of breast conserving surgery (BCS) is to excise the cancer with clear margins whilst at the same time leaving a good or excellent cosmetic result. A significant percentage of women, who have large cancers or have limited breast volumes, achieve poor cosmetic outcomes. BCS with immediate volume replacement using lipofilling or autologous fat transfer is a new technique. The aim of this study was to evaluate the cosmetic outcomes of a pilot study of patients having BCS and immediate lipofilling performed in The Edinburgh Breast Unit.
Questionnaires were mailed to 35 women who had BCS with immediate lipofilling and completed by 32 and results compared with those from a contemporary series of 39 women who had BCS alone. The cancers were significantly larger in the lipofilling group (median 21 mm vs. 16 mm p = 0.011) and the patients were non-significantly younger (median age 49 years vs. 54 p = 0.06).
At a median follow-up of 36 months, results from the Breast Q™ questionnaire showed significantly better cosmetic outcomes with lipofilling (most p < 0.001) and less local breast symptoms (p = 0.0045). There have been no local recurrences in either group and only 1 of the 35 patients was recalled following post-operative surveillance annual mammography.
BCS and immediate lipofilling provides superior cosmetic outcomes to standard BCS.
保乳手术（BCS）的目的是在切除肿瘤时保证切缘阴性，同时获得良好或极佳的美容效果。很大一部分患有较大肿瘤或乳房体积较小的女性美容效果较差。采用脂肪填充或自体脂肪移植进行即刻容量替代的保乳手术是一项新技术。本研究的目的是评估在爱丁堡乳腺科对接受保乳手术并即刻进行脂肪填充的患者进行的一项初步研究的美容效果。
向35例接受保乳手术并即刻进行脂肪填充的女性邮寄问卷，32例完成问卷，将结果与同期39例单纯接受保乳手术的女性进行比较。脂肪填充组的肿瘤明显更大（中位数21毫米对16毫米，p = 0.011），患者年龄稍小但差异无统计学意义（中位数年龄49岁对54岁，p = 0.06）。
在中位随访36个月时，乳房Q™问卷结果显示，脂肪填充组的美容效果明显更好（大多数p < 0.001），局部乳房症状更少（p = 0.0045）。两组均无局部复发，35例患者中仅1例在术后年度乳房X线摄影监测后被召回。
保乳手术并即刻进行脂肪填充比标准保乳手术具有更好的美容效果。
