Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary.
Department of Breast Surgery, Guy's and St Thomas's Hospitals NHS Foundation Trust, London, United Kingdom.
Clin Breast Cancer. 2019 Jun;19(3):e459-e467. doi: 10.1016/j.clbc.2019.02.005. Epub 2019 Feb 20.
This study presents a novel Level I oncoplastic breast-conserving surgery technique for performing tumorectomy by retroglandular exploration through a skin incision made in the inferior mammary fold.
A retrospective single-center cohort study involving patients with early-stage breast cancer (n = 102) was performed. The patient characteristics were recorded, as well as the quality of life rated by BREAST-Q. Postoperative complications were assessed using the Clavien-Dindo classification system. Esthetic outcomes were evaluated with Breast Cancer Conservative Treatment-cosmetic results (BCCT.core) software and a 5-point Likert scale.
The median follow-up time was 11 months (range, 7-25 months). The median specimen weight and operative time were 49.8 g (range, 13.4-117.9 g) and 40 minutes (range, 20-80 minutes), respectively. The mean pathologic tumor size was 15 mm (SD, ±7). Owing to positive surgical margins, re-excisions and mastectomies were performed in 13.7% and 2.9% of patients, respectively. The overall complication rate was 24.5% (n = 25), with the most common being seroma formation (13.7%; n = 14). The median Likert scale score was 4.3 (range, 2.1-5), and the median overall esthetic outcome assessed by BCCT.core was 2.1 points (range, 1-4 points). In BREAST-Q domains, the median scores of the "adverse effects of radiation," "physical well-being," the "satisfaction with breasts," and the "psychosocial well-being" were 27, 35, 90, and 93, respectively.
Retroglandular oncoplastic breast-conserving surgery is a novel, effective Level I oncoplastic technique for radical resection of breast tumors ≤ 3 cm in size. Additional advantages include the preservation of natural breast shape, the safety of the technique, and the lack of a need for contralateral symmetrization.
本研究提出了一种新的 I 级保乳肿瘤切除术式，通过在下乳褶线下的皮肤切口进行经乳腺后入路肿瘤切除术。
回顾性单中心队列研究纳入了 102 例早期乳腺癌患者。记录了患者特征，以及 BREAST-Q 评估的生活质量。采用 Clavien-Dindo 分类系统评估术后并发症。使用乳腺癌保乳治疗美容结果（BCCT.core）软件和 5 分李克特量表评估美容效果。
中位随访时间为 11 个月（7-25 个月）。中位标本重量和手术时间分别为 49.8 克（13.4-117.9 克）和 40 分钟（20-80 分钟）。平均病理肿瘤大小为 15 毫米（标准差，±7）。由于切缘阳性，分别有 13.7%和 2.9%的患者需要再次切除和乳房切除术。总的并发症发生率为 24.5%（25 例），最常见的是血清肿形成（13.7%；14 例）。Likert 量表评分中位数为 4.3（2.1-5），BCCT.core 评估的总体美容效果中位数为 2.1 分（1-4 分）。在 BREAST-Q 各领域中，“放射治疗的不良反应”、“身体状况”、“对乳房的满意度”和“社会心理状况”的中位数评分分别为 27、35、90 和 93。
经乳腺后入路保乳肿瘤切除术是一种新的 I 级保乳肿瘤切除术式，可用于根治性切除≤3 厘米的乳腺肿瘤。该术式的额外优点包括保持自然乳房形状、技术安全性以及无需对侧对称化。
