O'Halloran N, Lowery A, Kalinina O, Sweeney K, Malone C, McLoughlin R, Kelly J, Hussey A, Kerin M
Department of Surgery National University of Ireland Galway Galway Ireland.
Department of Mathematics National University of Ireland Galway Galway Ireland.
BJS Open. 2017 Nov 13;1(5):148-157. doi: 10.1002/bjs5.23. eCollection 2017 Oct.
Breast reconstruction is an important component of multidisciplinary breast cancer management. The practice of breast reconstruction after mastectomy has evolved significantly in the past decade as a result of both increasing mastectomy rates and advances in reconstructive strategy. These changes have significantly influenced the contemporary surgical management of breast cancer. The aim of this study was to examine trends in breast reconstruction after mastectomy in an Irish population.
Data were reviewed from a database of all patients who had mastectomy with or without breast reconstruction at Galway University Hospital, a tertiary breast cancer referral centre, between 2004 and 2014. Trends in breast reconstruction after mastectomy were explored with respect to patient demographics, clinicopathological features, and neoadjuvant and adjuvant therapy.
Of 1303 patients who underwent mastectomy during interval studied, 706 (54.2 per cent) had breast reconstruction after mastectomy. In 629 patients (89·1 per cent), breast reconstruction was performed in the immediate setting. Reconstruction rates increased over time from 20·5 per cent in 2004 to 44·7 per cent in 2014. Reconstruction was more commonly performed in younger patients and those with benign, in situ and early-stage disease. A negative relationship between radiotherapy and reconstruction was observed. A pedicled flap with or without an implant was the most commonly used reconstructive approach in patients receiving radiotherapy.
Breast reconstruction after mastectomy has become the standard of care in the surgical treatment of breast cancer. Recent trends show a transition favouring implant-based approaches.
乳房重建是多学科乳腺癌治疗的重要组成部分。由于乳房切除术率的上升和重建策略的进步，乳房切除术后乳房重建的实践在过去十年中发生了显著演变。这些变化对当代乳腺癌的外科治疗产生了重大影响。本研究的目的是调查爱尔兰人群乳房切除术后乳房重建的趋势。
回顾了戈尔韦大学医院（一家三级乳腺癌转诊中心）2004年至2014年间所有接受或未接受乳房重建的乳房切除术患者的数据库。探讨了乳房切除术后乳房重建在患者人口统计学、临床病理特征以及新辅助和辅助治疗方面的趋势。
在研究期间接受乳房切除术的1303例患者中，706例（54.2%）在乳房切除术后进行了乳房重建。在629例患者（89.1%）中，乳房重建在即时情况下进行。重建率随时间从2004年的20.5%上升至2014年的44.7%。重建在年轻患者以及患有良性、原位和早期疾病的患者中更常进行。观察到放疗与重建之间存在负相关关系。带蒂皮瓣联合或不联合植入物是接受放疗患者中最常用的重建方法。
乳房切除术后乳房重建已成为乳腺癌外科治疗的标准治疗方法。近期趋势显示向基于植入物的方法转变。
