In Seok Kyung, Kim Yoon Soo, Kim Ho Sung, Park Jin Hyung, Kim Hong Il, Yi Hyung Suk, Park Jea Chun, Jeon Chang Wan, Choi Jin Hyuk, Jung Sung Ui, Kim Hyo Young
Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Busan, Korea.
Department of Radiology, Kosin University Gospel Hospital, Busan, Korea.
Arch Plast Surg. 2020 Nov;47(6):574-582. doi: 10.5999/aps.2020.00325. Epub 2020 Nov 15.
Several oncoplastic approaches have been implemented in recent years to enhance cosmetic results and to reduce complications. The round block technique is a volume displacement technique for breast reconstruction after breast-conserving surgery (BCS). However, its indications are currently limited according to tumor location, and its cosmetic results and complications have not been clearly established. We hypothesized that the round block technique could produce favorable cosmetic results without major complications regardless of tumor location or nipple-tumor distance, below a certain resected tumor volume and tumor-breast volume ratio.
All breast reconstructions using the round block technique after BCS were included in this analysis. Patients' data were reviewed retrospectively to investigate complications during follow-up, and clinical photos were used to evaluate cosmetic results. The relationships of tumor location, nipple-tumor distance, tumor volume, and the tumor-breast volume ratio with cosmetic results were investigated.
In total, 108 breasts were reconstructed. The mean resected tumor volume was 30.2±15.0 mL. The cosmetic score was 4.5±0.6 out of 5. Tumor location, nipple-tumor distance, tumor volume, tumor-breast volume ratio, radiotherapy, and chemotherapy had no significant effects on cosmetic results or complications. There were no major complications requiring reoperation.
Breast reconstruction using the round block technique after BCS can lead to good cosmetic results without major complications regardless of the tumor location, nipple-tumor distance, radiotherapy, or chemotherapy. Below the maximum tumor volume (79.2 mL) and the maximum tumor-breast volume ratio (14%), favorable results were consistently obtained.
近年来已实施了几种肿瘤整形方法以提高美容效果并减少并发症。圆形块技术是一种用于保乳手术（BCS）后乳房重建的容积置换技术。然而，目前其适应证根据肿瘤位置受到限制，其美容效果和并发症尚未明确确立。我们假设，在一定的切除肿瘤体积和肿瘤-乳房体积比以下，无论肿瘤位置或乳头-肿瘤距离如何，圆形块技术都能产生良好的美容效果且无重大并发症。
本分析纳入了所有BCS后使用圆形块技术进行的乳房重建。回顾性审查患者数据以调查随访期间的并发症，并使用临床照片评估美容效果。研究了肿瘤位置、乳头-肿瘤距离、肿瘤体积和肿瘤-乳房体积比与美容效果之间的关系。
共重建了108个乳房。平均切除肿瘤体积为30.2±15.0 mL。美容评分为4.5±0.6（满分5分）。肿瘤位置、乳头-肿瘤距离、肿瘤体积、肿瘤-乳房体积比、放疗和化疗对美容效果或并发症无显著影响。没有需要再次手术的重大并发症。
BCS后使用圆形块技术进行乳房重建，无论肿瘤位置、乳头-肿瘤距离、放疗或化疗如何，均可获得良好的美容效果且无重大并发症。在最大肿瘤体积（79.2 mL）和最大肿瘤-乳房体积比（14%）以下，始终可获得良好结果。
