Rocco Nicola, Catanuto Giuseppe, Nava Maurizio B
Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy -
Group for REconstructive and Therapeutic Advancements (G.RE.T.A.), Milan, Naples, Catania, Italy -
Minerva Chir. 2018 Jun;73(3):322-328. doi: 10.23736/S0026-4733.18.07615-0. Epub 2018 Jan 23.
Indications for post mastectomy radiotherapy are widening to a larger group of mastectomy patients and breast reconstruction rates following mastectomy are rising all over the world, this leading breast surgeons to face breast reconstruction in a growing number of patients who will undergo radiotherapy. Increased morbidity is associated with all forms of breast reconstruction in the setting of postmastectomy radiotherapy and in patients who previously underwent chest wall radiotherapy. Different attitudes towards breast reconstruction in the radiotherapy setting are presented in literature. The level of evidence and quality of studies investigating breast reconstruction in the setting of PMRT and in patients who previously underwent chest wall radiotherapy are low. The reconstructive option in the radiotherapy setting must be tailored on the single patient according with patients' characteristics and wishes, always considering that the best reconstructive timing must be driven by the best oncological timing.
乳房切除术后放疗的适应证正在扩大到更多的乳房切除患者群体,并且世界各地乳房切除术后的乳房重建率都在上升,这使得乳腺外科医生面临越来越多将要接受放疗的患者的乳房重建问题。在乳房切除术后放疗的情况下以及先前接受过胸壁放疗的患者中,各种形式的乳房重建都会增加发病率。文献中呈现了在放疗背景下对乳房重建的不同态度。研究乳房切除术后放疗以及先前接受过胸壁放疗的患者进行乳房重建的证据水平和研究质量较低。放疗背景下的重建方案必须根据患者的特征和意愿为个体患者量身定制,始终要考虑到最佳的重建时机必须由最佳的肿瘤治疗时机来决定。