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乳腺切除术联合即刻重建术治疗早期浸润性乳腺癌患者:一项队列研究。

Mammary adenectomy followed by immediate reconstruction for treatment of patients with early-infiltrating breast carcinoma: a cohort study.

作者信息

Barros Alfredo Carlos Simões Dornellas de, Carvalho Heloísa Andrade, Andrade Felipe Eduardo Martins, Nimir Cristiane da Costa Bandeira Abrahão, Sampaio Marcelo Moura Costa, Makdissi Fabiana Baroni, Mano Max Senna

机构信息

MD, PhD. Breast Surgeon, Hospital Sírio-Libanês, São Paulo (SP), Brazil.

MD, PhD. Radiation Oncologist, Hospital Sírio-Libanês, São Paulo (SP), Brazil.

出版信息

Sao Paulo Med J. 2019 Oct 31;137(4):336-342. doi: 10.1590/1516-3180.2018.0356220719. eCollection 2019.

Abstract

BACKGROUND

Use of mammary adenectomy for breast carcinoma treatment remains controversial.

OBJECTIVE

This study aimed to verify the oncological safety of mammary adenectomy and immediate breast reconstruction for treating selected patients with infiltrating breast carcinoma and to evaluate patients' satisfaction with the reconstructed breasts.

DESIGN AND SETTING

Cohort study conducted among patients treated at Hospital Sírio-Libanês, São Paulo, Brazil.

METHODS

This study was based on 152 selected patients (161 operated breasts) with infiltrating breast carcinoma who underwent mammary adenectomy and immediate breast reconstruction. In all patients, the diameter of the largest focus of the tumor was less than 3.0 cm, the imaging tumor-nipple distance was greater than 2.0 cm and the pathological assessment showed clear margins. The cumulative incidence of local recurrence (LR), recurrence-free survival (RFS) and overall survival (OS) curves were estimated using the Kaplan-Meier method. After at least one year of follow-up, 64 patients were asked about their satisfaction with the reconstructed breast(s).

RESULTS

At a mean follow-up time of 43.5 months, seven cases of LR (4.4%), four distant metastases (2.6%) and five deaths (3.3%) were recorded. The five-year actuarial LR-free survival, RFS and OS were 97.6%, 98.3% and 98.3%, respectively. No cases of nipple-areolar complex recurrence were reported. Forty-one patients (64%) indicated a high level of satisfaction with the reconstructed breasts.

CONCLUSIONS

Mammary adenectomy is a safe and efficacious procedure for selected patients with early-infiltrating breast carcinoma and results in a high rate of patient satisfaction with the reconstructed breasts.

摘要

背景

采用乳腺切除术治疗乳腺癌仍存在争议。

目的

本研究旨在验证乳腺切除术及即刻乳房重建术治疗特定浸润性乳腺癌患者的肿瘤学安全性,并评估患者对重建乳房的满意度。

设计与地点

在巴西圣保罗的黎巴嫩叙利亚医院对患者进行的队列研究。

方法

本研究基于152例选定的浸润性乳腺癌患者(161个手术乳房),这些患者接受了乳腺切除术及即刻乳房重建术。所有患者肿瘤最大病灶直径均小于3.0 cm,影像学肿瘤-乳头距离大于2.0 cm,病理评估显示切缘清晰。采用Kaplan-Meier方法估计局部复发(LR)、无复发生存(RFS)和总生存(OS)曲线的累积发生率。在至少随访一年后,询问64例患者对重建乳房的满意度。

结果

平均随访时间为43.5个月,记录到7例LR(4.4%)、4例远处转移(2.6%)和5例死亡(3.3%)。五年精算无LR生存率、RFS和OS分别为97.6%、98.3%和98.3%。未报告乳头乳晕复合体复发病例。41例患者(64%)对重建乳房表示高度满意。

结论

对于选定的早期浸润性乳腺癌患者,乳腺切除术是一种安全有效的手术,患者对重建乳房的满意度较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a6a/9744021/64db9d33c5da/1806-9460-spmj-137-04-336-gf1.jpg

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