Campbell Esther Jennifer, Romics Laszlo
Department of Plastic Surgery, Glasgow Royal Infirmary.
Department of Surgery, New Victoria Hospital Glasgow.
Breast Cancer (Dove Med Press). 2017 Aug 4;9:521-530. doi: 10.2147/BCTT.S113742. eCollection 2017.
Oncoplastic breast conservation surgery (OBCS) is increasingly becoming part of routine breast cancer surgical management. OBCS may be viewed as an extension of standard breast conservation surgery for resecting tumors of larger sizes without compromising on cosmetic outcome, or as an alternative to mastectomy. High quality evidence to support the oncological safety and benefits of OBCS is lacking. This review will focus on the best available level of evidence and address key issues regarding oncological safety in OBCS, such as tumor resection margins and re-excision rates, local recurrence and patient outcome, postoperative complications and adjuvant therapy delivery, and briefly discuss cosmetic outcome in OBCS. Comparative observational studies and systematic review report no poorer outcomes compared with standard breast conservation surgery. More evidence needs to be generated to support the oncological safety and improved aesthetic outcome. Prospective data collection will significantly contribute to the generation of stronger evidence.
肿瘤整形保乳手术(OBCS)正日益成为常规乳腺癌手术治疗的一部分。OBCS可被视为标准保乳手术的扩展,用于切除更大尺寸的肿瘤而不影响美容效果,或者作为乳房切除术的替代方案。目前缺乏支持OBCS肿瘤学安全性和益处的高质量证据。本综述将聚焦于现有最佳证据水平,并探讨OBCS肿瘤学安全性的关键问题,如肿瘤切除边缘和再次切除率、局部复发和患者预后、术后并发症和辅助治疗的实施,并简要讨论OBCS的美容效果。比较性观察研究和系统评价报告显示,与标准保乳手术相比,OBCS的预后并不更差。需要更多证据来支持其肿瘤学安全性和改善美学效果。前瞻性数据收集将显著有助于产生更有力的证据。