Kim Min Wook, Oh Won Seok, Lee Jae Woo, Kim Hyun Yul, Jung Youn Joo, Choo Ki Seok, Nam Kyung Jin, Bae Seong Hwan, Kim Choongrak, Nam Su Bong, Joo Ji Hyeon
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea.
Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
Arch Plast Surg. 2020 Nov;47(6):583-589. doi: 10.5999/aps.2020.01123. Epub 2020 Nov 15.
Reduction mammoplasty or mastopexy is performed as an additional balancing procedure in patients with large or ptotic breasts who undergo breast-conserving surgery (BCS). Radiation therapy on breasts that have undergone surgery may result in changes in the volume. This study presents a comparative analysis of patients who received post-BCS balancing procedures to determine whether volume changes were larger in breasts that received radiation therapy than on the contralateral side.
Thirty-six participants were selected among patients who received BCS using the inverted-T scar technique between September 2012 and July 2017, were followed up for 2 or more years, and had pre-radiation therapy computed tomography images and post-radiation therapy images taken between 12 and 18 months after completion. The average age of the participants was 53.5 years, their average body mass index was 26.62 kg/m2.
The pre- and post-radiation therapy volumes of the breasts receiving BCS were 666.08±147.48 mL and 649.33±130.35 mL, respectively. In the contralateral breasts, the volume before radiation therapy was 637.69±145.72 mL, which decreased to 628.14±166.41 mL after therapy. The volume ratio of the affected to the contralateral breasts was 1.05±0.10 before radiation therapy and 1.06±0.12 after radiation therapy.
The ratio of the volume between the two breasts immediately after surgery and at roughly 18 months postoperatively was not significantly different (P=0.98). For these reasons, we recommend a simultaneous single-stage balancing procedure as a reasonable option for patients who require radiation therapy after BCS without concerns regarding volume change.
对于接受保乳手术(BCS)的乳房较大或下垂的患者,缩乳术或乳房固定术作为一种额外的平衡手术进行。接受过手术的乳房进行放射治疗可能会导致体积变化。本研究对接受BCS后平衡手术的患者进行了比较分析,以确定接受放射治疗的乳房的体积变化是否大于对侧乳房。
在2012年9月至2017年7月期间采用倒T形瘢痕技术接受BCS的患者中选择36名参与者,随访2年或更长时间,并在完成后12至18个月拍摄放疗前计算机断层扫描图像和放疗后图像。参与者的平均年龄为53.5岁,平均体重指数为26.62kg/m²。
接受BCS的乳房放疗前和放疗后的体积分别为666.08±147.48mL和649.33±130.35mL。在对侧乳房中,放疗前的体积为637.69±145.72mL,放疗后降至628.14±166.41mL。放疗前患侧与对侧乳房的体积比为1.05±0.10,放疗后为1.06±0.12。
手术后即刻和术后约18个月时两侧乳房的体积比无显著差异(P=0.98)。基于这些原因,我们建议对于BCS后需要放疗的患者,同时进行单阶段平衡手术是一个合理的选择,无需担心体积变化。