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标准保乳术的替代方法:加拿大环境下整形保乳术治疗结果的 5 年病例系列回顾。

An alternative to standard lumpectomy: a 5-year case series review of oncoplastic breast surgery outcomes in a Canadian setting.

机构信息

From Western University, London, Ont. (Knowles, Brackstone); the University of Nebraska Medical Center, Omaha, Neb. (Maxwell); Georgian College, Barrie, Ont. (Lumsden, Pearson, Pulhin); Royal Victoria Regional Health Centre, Barrie, Ont. (McLean, Hanrahan); and McMaster University, Hamilton, Ont. (Hanrahan).

出版信息

Can J Surg. 2020 Jan 29;63(1):E46-E51. doi: 10.1503/cjs.003819.

Abstract

BACKGROUND

Oncoplastic surgery (OPS) is becoming the new standard of care for breast-conserving surgery (BCS). It has become increasingly popular in Europe; however, it has not yet been widely accepted in North America. This study aims to describe the experience with OPS at a Canadian tertiary care centre.

METHODS

This study is a retrospective case series consisting of consecutive OPS cases at a single Canadian centre, the Royal Victoria Regional Health Centre in Barrie, Ontario, between 2009 and 2015.

RESULTS

A total of 275 women who consecutively underwent OPS were included. The average size of the tumour was 17 mm (standard deviation [SD] 13 mm; range 0–110 mm). The average specimen weight was 155 g (SD 146 g; range 15–1132 g). Invasive ductal carcinoma was the most common diagnosis (237 patients, 86.2%), followed by ductal carcinoma in situ (18 patients, 6.6%) and then invasive lobular carcinoma (15 patients, 5.5%). A positive margin was recorded in 37 (13.5%) patients. Immediate postoperative complications included seroma and edema (32.7%), wound infection (13.1%), hematoma (8.7%) and delayed wound healing (6.5%). A delay to adjuvant therapy due to postoperative complications occurred in 7 of 217 (3.2%) patients. The median follow-up was 18 months. There were local and distant recurrences in 9 (3.3%) and 2 (0.7%) patients, respectively. Overall survival was 99.3%.

CONCLUSION

The findings of this study are comparable to results in the literature on OPS and demonstrate that OPS is an attractive alternative to standard lumpectomy for Canadian general surgeons who treat breast cancer.

摘要

背景

肿瘤整形术(OPS)正在成为保乳手术(BCS)的新标准。它在欧洲越来越受欢迎;然而,在北美尚未得到广泛接受。本研究旨在描述加拿大一家三级保健中心的 OPS 经验。

方法

本研究是一项回顾性病例系列研究,纳入了 2009 年至 2015 年期间在加拿大安大略省巴里的皇家维多利亚地区医疗中心接受 OPS 的连续病例。

结果

共纳入 275 例连续接受 OPS 的女性患者。肿瘤的平均大小为 17 毫米(标准差 [SD] 13 毫米;范围 0-110 毫米)。标本的平均重量为 155 克(SD 146 克;范围 15-1132 克)。最常见的诊断是浸润性导管癌(237 例,86.2%),其次是导管原位癌(18 例,6.6%)和浸润性小叶癌(15 例,5.5%)。37 例(13.5%)患者记录到阳性切缘。术后并发症包括血清肿和水肿(32.7%)、伤口感染(13.1%)、血肿(8.7%)和延迟伤口愈合(6.5%)。217 例患者中有 7 例(3.2%)因术后并发症而延迟辅助治疗。中位随访时间为 18 个月。9 例(3.3%)患者出现局部和远处复发,2 例(0.7%)患者出现远处复发。总生存率为 99.3%。

结论

本研究的结果与 OPS 的文献结果相当,表明 OPS 是加拿大普通外科医生治疗乳腺癌的标准乳房切除术的一种有吸引力的替代方法。

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