Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands.
Br J Radiol. 2020 Oct 1;93(1114):20190994. doi: 10.1259/bjr.20190994. Epub 2020 Jul 20.
Better cosmetic outcome after vacuum assisted excision (VAE) compared to surgical excision of benign breast lesions is suggested in previous studies but has never been evaluated with validated outcome measures. In this study, patient reported cosmetic outcome after VAE was evaluated.
Patients who underwent VAE between July 2017 and December 2018 were invited to complete the cosmetic subscale of the Dutch Breast Cancer Treatment Outcome Scale, comparing the treated with the untreated breast. Response mode ranged from 1 (no difference) to 4 (large difference) and cosmetic outcome was calculated as the unweighted mean. Clinical outcomes included: tumor size, number of cores, complications, residual lesions and recurrences.
Response rate was 73.4% (47 of 64 patients). Median tumor size was 15 mm (range 5-51 mm) and median number of cores 6.5 (range 1-85), complete excision was confirmed in all but two patients. Mean cosmetic outcome was good (mean score ≤1.75) in 74% of patients and no patients reported a poor cosmetic outcome (mean score >3.25). A hematoma occurred in five patients (one needed aspiration) and a skin rash in one patient, no patients developed an infection or seroma.
In this study VAE is safe and effective for tumors up to 5 cm and patient reported cosmetic outcome was good. Patients with benign lesions could benefit from VAE as an alternative for surgical excision.
A formal quantitative measurement of cosmetic outcome after vacuum assisted excision for benign breast lesions was still lacking. This study shows that this cosmetic outcome is overall good in benign lesions up to 5 cm.
先前的研究表明,与良性乳腺病变的手术切除相比,真空辅助切除(VAE)后的美容效果更好,但从未用经过验证的结局测量指标进行评估。本研究评估了 VAE 后患者报告的美容结局。
邀请 2017 年 7 月至 2018 年 12 月期间接受 VAE 的患者完成荷兰乳腺癌治疗结局量表的美容亚量表,比较治疗侧和未治疗侧乳房。反应模式范围从 1(无差异)到 4(差异大),美容结局的计算方法为未加权平均值。临床结局包括:肿瘤大小、核心数量、并发症、残留病变和复发。
应答率为 73.4%(64 例患者中的 47 例)。中位肿瘤大小为 15mm(范围 5-51mm),中位核心数量为 6.5(范围 1-85),除两名患者外,所有患者均证实完全切除。74%的患者美容结局良好(平均评分≤1.75),无患者报告美容结局差(平均评分>3.25)。五名患者发生血肿(一名需要抽吸),一名患者出现皮疹,无患者发生感染或血清肿。
在这项研究中,VAE 对于直径达 5cm 的肿瘤是安全有效的,且患者报告的美容效果良好。良性病变患者可从 VAE 作为手术切除的替代方法中获益。
良性乳腺病变 VAE 后美容结局的定量评估方法仍缺乏。本研究表明,5cm 以下良性病变的美容结局总体良好。