年轻乳腺癌患者保皮乳房切除术即刻重建的肿瘤安全性。
Oncologic safety of skin-sparing mastectomy followed by immediate reconstruction in young patients with breast cancer.
机构信息
Division of Breast and Endocrine Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Department of Plastic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
出版信息
Asian J Surg. 2019 Jan;42(1):274-282. doi: 10.1016/j.asjsur.2018.04.004. Epub 2018 Jun 13.
BACKGROUNDS
This study aimed to compare the oncologic outcomes of nipple-sparing mastectomy (NSM)/skin-sparing mastectomy (SSM) followed by immediate reconstruction with those of conventional mastectomy (CM) in young patients aged under 35 years old with breast cancer.
METHODS
We analyzed retrospectively 2889 patients who underwent mastectomy for breast cancer at Asan Medical Center from January 2003 to December 2008. We compared NSM/SSM followed by immediate reconstruction with CM in patients under 35 years old by analyzing clinicopathologic features, breast cancer specific survival rate (BCSS), distant metastasis free survival rate (DMFS), and local recurrence rate (LRR).
RESULTS
Out of a total of 2889 patients, we performed NSM/SSM in 118 patients and CM in 141 patients aged less than 35 years old. DMFS were 85.3% and 73.4% in NSM/SSM and CM, respectively (p = 0.001). BCSS were 90.7% and 73.0% in NSM/SSM and CM, respectively (p = 0.001). After adjusting for stage, there were no statistically significant differences between the two groups with respect to DMFS and BCSS. The type of surgery was not a prognostic factor in multivariate analysis for DMFS and BCSS (CM vs. NSM/SSM: DMFS HR = 0.67, p = 0.215; BCSS: HR = 0.66, p = 0.265).
CONCLUSIONS
Compared to CM, NSM/SSM followed by immediate breast reconstruction is oncologically safe and could be a viable surgical treatment in young patients under 35 years old with breast cancer.
背景
本研究旨在比较 35 岁以下乳腺癌患者行保乳头乳晕乳腺切除术（NSM）/保留皮肤的乳腺切除术（SSM）联合即刻重建与传统乳房切除术（CM）的肿瘤学结果。
方法
我们回顾性分析了 2003 年 1 月至 2008 年 12 月在 Asan 医疗中心行乳房切除术的 2889 例乳腺癌患者。通过分析临床病理特征、乳腺癌特异性生存率（BCSS）、远处无转移生存率（DMFS）和局部复发率（LRR），比较了 35 岁以下患者的 NSM/SSM 联合即刻重建与 CM。
结果
在 2889 例患者中，我们对 118 例年龄小于 35 岁的患者行 NSM/SSM，对 141 例年龄小于 35 岁的患者行 CM。NSM/SSM 和 CM 的 DMFS 分别为 85.3%和 73.4%（p=0.001）。NSM/SSM 和 CM 的 BCSS 分别为 90.7%和 73.0%（p=0.001）。调整分期后，两组间 DMFS 和 BCSS 无统计学差异。多因素分析中手术类型不是 DMFS 和 BCSS 的预后因素（CM 与 NSM/SSM：DMFS HR=0.67，p=0.215；BCSS：HR=0.66，p=0.265）。
结论
与 CM 相比，NSM/SSM 联合即刻乳房重建在肿瘤学上是安全的，对于 35 岁以下乳腺癌患者来说，这可能是一种可行的治疗方法。
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