Johnson Miguel, Cook Lorna, Rapisarda Fabio I, Betal Dibendu, Bonomi Riccardo
Queen Victoria Hospital NHS Trust, Department of Plastic Reconstruction & Aesthetic Surgery, England, UK.
Worthing Hospital, Western Sussex Hospitals NHS Foundation Trust, Division of Breast Surgery, Worthing, UK.
J Surg Case Rep. 2020 Sep 9;2020(9):rjaa285. doi: 10.1093/jscr/rjaa285. eCollection 2020 Sep.
The introduction of breast conservation surgery together with advances in oncoplastic techniques has revolutionized the management of retroareolar breast tumours. Traditionally, cancers in this location were often managed with central excision and primary closure or mastectomy. More recently, oncoplastic breast-conserving techniques such as the Grisotti mammoplasty have been increasingly encouraged as an alternative option as it allows oncological safe margin resections while restoring cosmesis. The use of a Grisotti flap enables safe resection of a retroareolar tumour with concurrent reconstruction of the defect using a local rotational advancement dermoglandular flap allowing a satisfactory cosmetic result in term of contour and projection. This technique is often limited to those patients with sufficient native nipple-inferior mammary fold (IMF) distance to accommodate for some inevitable post-operative reduction in this distance. We describe a modification of the original description, such that satisfactory cosmetic outcome can be achieved, even in patients with a short nipple areolar complex to inframammary fold distance.
保乳手术的引入以及肿瘤整形技术的进步彻底改变了乳晕后乳腺肿瘤的治疗方式。传统上，该部位的癌症通常采用中央切除加一期缝合或乳房切除术进行治疗。最近，越来越多的人鼓励采用肿瘤整形保乳技术，如格里索蒂乳房成形术，作为一种替代选择，因为它既能实现肿瘤学安全切缘切除，又能恢复美观。使用格里索蒂皮瓣能够安全切除乳晕后肿瘤，同时使用局部旋转推进皮瓣修复缺损，从而在轮廓和突出度方面获得令人满意的美容效果。该技术通常仅限于那些乳头至乳腺下皱襞（IMF）距离足够的患者，以适应术后该距离不可避免的缩短。我们描述了对原始描述的一种改进，即使在乳头乳晕复合体至乳腺下皱襞距离较短的患者中，也能实现令人满意的美容效果。
