Surgical Sciences Department, "Sapienza" University of Rome, Viale Regina Elena 261, 00161 Rome, Italy.
Emergency Department, Aurelia Hospital, Via Aurelia, 860, 00165 Rome, Italy.
Medicina (Kaunas). 2020 Apr 8;56(4):166. doi: 10.3390/medicina56040166.
: The surgical choice treatment of the breast cancer mostly depends on the stage of the disease. In the last years, breast cancer surgery has moved from being destructive to being more respectful of the anatomical and physiological integrity of the gland. The aim of the breast surgery should be finalized to obtain the best aesthetic and functional results, respecting the principles of oncologic radicality. The present study is a retrospective analysis aimed to evaluate the long-term outcomes of a conservative technique like the nipple-sparing mastectomy. We observed 894 patients with a median age of 47.5 years old, underwent nipple-sparing mastectomy between 2002-2017. The data acquired include population and tumor characteristics, patient reconstructive outcomes, including locoregional, regional, and distant metastases; other variables, among nipple-areola complex necrosis and infection were collected. The complications detected were considered as "early" within 1 month later the nipple-sparing mastectomy or "late" after this time. The overall complications rate (early and late) and the overall survival and the relapses detected by this study were comparable with those reported in the literature. In order to identify factors that correlate with complications, either early or later, it has been processed an evaluation of the univariate analysis showing adjuvant chemotherapy as the only predictive factor for late complications, while we encountered no predictors for early complications. The present study adds to the data already present in literature, demonstrating that the nipple-sparing mastectomy is a safe procedure, providing good oncological and aesthetic results in patients carefully selected.
乳腺癌的手术治疗选择主要取决于疾病的阶段。近年来,乳腺癌手术已经从破坏性手术转变为更尊重腺体解剖和生理完整性的手术。乳房手术的目的应该是获得最佳的美学和功能效果,同时尊重肿瘤根治性的原则。本研究是一项回顾性分析,旨在评估保留乳头的乳房切除术等保守技术的长期效果。我们观察了 894 名年龄中位数为 47.5 岁的患者,他们在 2002 年至 2017 年间接受了保留乳头的乳房切除术。收集的数据包括人口统计学和肿瘤特征、患者的重建结果,包括局部区域、区域和远处转移;还收集了乳头乳晕复合体坏死和感染等其他变量。检测到的并发症被认为是在保留乳头的乳房切除术后 1 个月内的“早期”并发症或在此之后的“晚期”并发症。本研究中检测到的总体并发症发生率(早期和晚期)以及总体生存率和复发率与文献报道的相似。为了确定与并发症相关的因素,无论是早期还是晚期,我们进行了单因素分析评估,结果显示辅助化疗是晚期并发症的唯一预测因素,而我们没有发现早期并发症的预测因素。本研究增加了文献中已有的数据,表明保留乳头的乳房切除术是一种安全的手术,可以为精心选择的患者提供良好的肿瘤学和美学效果。