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一步一步的肿瘤整形保乳手术图谱,涵盖可重复的解剖技术和解剖学上理想的切口位置。

A step-by-step oncoplastic breast conservation surgical atlas of reproducible dissection techniques and anatomically ideal incision placement.

机构信息

Department of Surgery, Westchester Medical Center, 100 Woods Road, Valhalla, NY, USA.

出版信息

Breast Cancer Res Treat. 2017 Oct;165(3):505-516. doi: 10.1007/s10549-017-4344-z. Epub 2017 Jun 28.

Abstract

PURPOSE

To develop an atlas for oncoplastic surgery (OPS) with template dissection techniques via anatomically ideal incisions for breast conservation surgery. The evolution of breast conservation techniques has evolved from placing an incision directly over the lesion to the incorporation of a thoughtful decision making process utilizing oncoplastic surgical (OPS) techniques to combining OPS with incision placement in anatomically advantageous sites. The high survival rates of breast cancer and effect of breast surgery on quality of life reinforce emphasis of optimal oncologic as well as aesthetic outcome. OPS results in greater patient satisfaction, fewer surgeries, and is oncologically safe. Today's breast surgeon is tasked with optimizing both oncologic and aesthetic outcomes.

METHODS

Presentation of reproducible dissection techniques and incision placement strategies to afford surgeons a step-by-step approach of OPS via anatomically ideal incisions in breast conservation surgery.

RESULTS

Demonstration of reproducible techniques to facilitate the decision making process of optimal breast conservation surgery, eliminate knowledge gaps for surgeons, optimize outcome for individuals undergoing breast conservation surgery, and decrease disparity of care.

CONCLUSION

Adoption of OPS techniques utilizing an anatomically ideal incision in breast conservation surgery is a feasible and reproducible practice for breast surgeons. Application of these techniques results in maintained optimal shape, size, and contour without the typical overlying skin envelope scars. OPS techniques performed under the skin envelope result in expected OPS oncologic and aesthetic outcomes with the addition of the resulting scar(s) in anatomically discrete position(s).

摘要

目的

通过对乳腺癌保乳手术进行解剖学上理想的切口来开发用于肿瘤整形手术 (OPS) 的图谱,采用模板解剖技术。乳腺癌保乳技术的发展已经从直接在病变部位放置切口演变为结合肿瘤整形手术 (OPS) 技术,通过深思熟虑的决策过程,将 OPS 与解剖学优势部位的切口放置相结合。乳腺癌的高存活率和乳房手术对生活质量的影响强调了最佳肿瘤学和美学结果的重要性。OPS 可提高患者满意度、减少手术次数,并且具有肿瘤学安全性。如今,乳腺外科医生的任务是优化肿瘤学和美学结果。

方法

介绍可重复的解剖技术和切口放置策略,为外科医生提供通过在乳腺癌保乳手术中进行解剖学上理想的切口进行 OPS 的逐步方法。

结果

展示可重复的技术,以促进最佳乳腺癌保乳手术的决策过程,消除外科医生的知识差距,优化接受乳腺癌保乳手术的个体的结果,并减少护理差距。

结论

在乳腺癌保乳手术中采用 OPS 技术和解剖学上理想的切口是可行且可重复的乳腺外科实践。这些技术的应用可保持乳房的最佳形状、大小和轮廓,而不会出现典型的皮肤覆盖物疤痕。在皮肤覆盖物下进行 OPS 技术可产生预期的 OPS 肿瘤学和美学结果,并在解剖学上的离散位置产生相应的疤痕。

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