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使用乳腺癌保乳治疗美容效果软件(BCCT.core)对接受治疗性乳房整形术的乳腺癌患者的乳房对称性进行评估。

Assessment of breast symmetry in breast cancer patients undergoing therapeutic mammaplasty using the Breast Cancer Conservation Therapy cosmetic results software (BCCT.core).

作者信息

Vella Baldacchino Reuben, Bellizzi Annalise, Madada-Nyakauru Rudo N, Kazzazi Fawz, Oni Georgette, Forouhi Parto, Malata Charles M

机构信息

Mater Dei Hospital, Malta Medical School, University of Malta, Msida, Malta.

Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

出版信息

Gland Surg. 2019 Jun;8(3):218-225. doi: 10.21037/gs.2018.09.06.

Abstract

BACKGROUND

Therapeutic mammaplasty (TM) is a standard oncoplastic technique utilising aesthetic breast reduction principles to facilitate tumour resection and breast reshaping. Simultaneous contralateral mammaplasties are often performed to maintain symmetry. BCCT.core software, which principally assesses breast symmetry, has been previously employed for evaluating cosmetic results after standard breast conservation therapy and latterly TMs for upper pole tumours. The purpose of this study was to validate this novel tool for TMs in all breast zones.

METHODS

Standardised photographs of 20 consecutive patients who underwent TM were evaluated for symmetry using BCCT.core versus a plastic surgical panel completing a visual analogue scale. Results were rated as (excellent/good/fair/poor). Outcomes between the two methods were compared.

RESULTS

Twenty patients aged 37 to 63 years with a median 36G bra size had 22 TMs (18 unilateral, 2 bilateral). Indications were invasive breast cancer (87%) and ductal carcinoma in situ (DCIS) (13%). The median (range) tumour size was 22.5 mm (6-90 mm) with a resection weight of 245.8 g (16-1,079 g). Primary nipple pedicles were superomedial (63%), inferior (21%) and superolateral (16%). Five patients required a secondary glandular pedicle for volume redistribution to maintain breast shape. The BCCT.core software panel symmetry assessments were 37% 39% (excellent), 63% 50% (good) and 0% 11% (fair). Wilcoxon matched-pairs sign rank tests and Spearman rank correlations found the pairings to be statistically significant (P<0.05).

CONCLUSIONS

Despite small patient numbers, BCCT.core gave comparable findings with the panel and is thus useful for objectively assessing cosmesis of TMs in all breast zones.

摘要

背景

治疗性乳房整形术(TM)是一种标准的肿瘤整形技术,它利用美学乳房缩小原则来促进肿瘤切除和乳房重塑。通常会同时进行对侧乳房整形术以保持对称。BCCT.core软件主要用于评估乳房对称性,此前已被用于评估标准保乳治疗后的美容效果,最近也用于评估上极肿瘤的TM。本研究的目的是验证这一新型工具在所有乳房区域TM中的有效性。

方法

使用BCCT.core软件对20例连续接受TM的患者的标准化照片进行对称性评估,并与完成视觉模拟量表的整形外科小组进行比较。结果分为(优秀/良好/中等/差)。比较两种方法的结果。

结果

20例年龄在37至63岁之间、中位胸罩尺寸为36G的患者接受了22次TM手术(18例单侧,2例双侧)。手术指征为浸润性乳腺癌(87%)和导管原位癌(DCIS)(13%)。肿瘤大小中位数(范围)为22.5毫米(6 - 90毫米),切除重量为245.8克(16 - 1079克)。主要乳头蒂位于上内侧(63%)、下侧(21%)和上外侧(16%)。5例患者需要二次腺体蒂进行体积重新分配以维持乳房形状。BCCT.core软件小组的对称性评估为37% 39%(优秀),63% 50%(良好),0% 11%(中等)。Wilcoxon配对符号秩检验和Spearman秩相关分析发现配对具有统计学意义(P<0.05)。

结论

尽管患者数量较少,但BCCT.core软件与小组评估结果相当,因此可用于客观评估所有乳房区域TM的美容效果。

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本文引用的文献

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Oncoplastic Breast Surgery: What, When and for Whom?肿瘤整形乳房手术:是什么、何时进行以及适用于何人?
Curr Breast Cancer Rep. 2016;8:112-117. doi: 10.1007/s12609-016-0212-9. Epub 2016 May 3.
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Assessing cosmetic results after breast conserving surgery.评估保乳手术后的美容效果。
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