Department of Surgery, Tufts Medical Center, Boston, MA, USA.
Breast Health Center, Women and Infants' Hospital, Providence, RI, USA.
Ann Surg Oncol. 2019 Oct;26(11):3436-3444. doi: 10.1245/s10434-019-07345-4. Epub 2019 Apr 11.
Several definitions of oncoplastic surgery have been reported in the literature. In an effort to facilitate communication regarding oncoplastic surgery to patients, trainees, and among colleagues, the American Society of Breast Surgeons (ASBrS) aimed to create a consensus definition and classification system for oncoplastic surgery.
We performed a comprehensive literature search for oncoplastic surgery definitions using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Following this, a consensus definition and classification system was created by the ASBrS.
Overall, 30 articles defining oncoplastic surgery were identified, with several articles contradicting each other. The ASBrS definition for oncoplastic surgery defines this set of breast-conserving operations using volume displacement and volume replacement principles as: "Breast conservation surgery incorporating an oncologic partial mastectomy with ipsilateral defect repair using volume displacement or volume replacement techniques with contralateral symmetry surgery as appropriate". Volume displacement is defined as closing the lumpectomy defect and redistributing the resection volume over the preserved breast, and is divided into two levels: level 1 (< 20%) and level 2 (20-50%). Volume replacement includes those situations when volume is added using flaps or implants to correct the partial mastectomy defect.
The ASBrS oncoplastic surgery definition and classification system provides language to facilitate discussion and teaching of oncoplastic surgery among breast surgeons, trainees, and patients.
文献中已经报道了几种肿瘤整形手术的定义。为了促进患者、学员和同行之间关于肿瘤整形手术的交流,美国乳腺外科学会(ASBrS)旨在为肿瘤整形手术创建一个共识定义和分类系统。
我们按照系统评价和荟萃分析的首选报告项目指南对肿瘤整形手术的定义进行了全面的文献检索。在此基础上,ASBrS 制定了共识定义和分类系统。
总共确定了 30 篇定义肿瘤整形手术的文章,其中一些文章相互矛盾。ASBrS 对肿瘤整形手术的定义是使用体积置换和体积替换原则定义这组保乳手术的:“在同侧缺陷修复中结合肿瘤学部分乳房切除术的保乳手术,使用体积置换或体积替换技术,如有必要,还可进行对侧对称手术”。体积置换是指关闭肿瘤切除术的缺陷,并将切除的体积重新分布在保留的乳房上,分为 2 个级别:1 级(<20%)和 2 级(20-50%)。体积替换包括使用皮瓣或植入物来纠正部分乳房切除术缺陷的情况。
ASBrS 的肿瘤整形手术定义和分类系统为乳腺外科医生、学员和患者之间关于肿瘤整形手术的讨论和教学提供了语言。