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肿块样肉芽肿性小叶性乳腺炎Ⅰ期植入式乳房重建的临床观察

A clinical observation of stage I implant breast reconstruction for mass-like granulomatous lobular mastitis.

作者信息

Zhang Chaojie, Wu Yaqin, Wang Huiling, Zeng Jie, Lei Shanshan, He Jie, Zeng Zheng, Wu Runzhang, Li Qian, Fan Peizhi

机构信息

Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha, China.

Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Hunan Normal University/Hunan Provincial People's Hospital, Changsha, China.

出版信息

Gland Surg. 2021 Sep;10(9):2663-2672. doi: 10.21037/gs-21-417.

Abstract

BACKGROUND

Granulomatous lobular mastitis (GLM) is a chronic benign inflammatory breast disease, and mainly mass-like granulomatous lobular mastitis (MGLM) clinically. There are few reports on applications of stage I implant breast reconstruction in GLM. This observational study was conducted to evaluate the safety and efficacy of stage I implant breast reconstruction in the treatment of MGLM.

METHODS

Patients suffering from MGLM who visited at hospital from April 2019 to June 2020 were selected and graded according to the magnetic resonance imaging (MRI) examination. Patients with MGLM were grouped into the prosthesis implantation group and the traditional treatment group according to their preferences. Clinical parameters of the two groups were analyzed before and after surgery, such as postoperative infection, recurrence, and satisfaction with appearance and aesthetics were observed. To evaluate the safety and efficacy of the implant breast reconstruction in MGLM.

RESULTS

There were 59 cases of MGLM, 31 cases of grade 3-4 GLM, 11 cases of bilateral metachronous GLM. There were 18 patients in the prosthesis implantation group, including 9 patients with bilateral metachronous GLM, 2 patients with synchronous GLM, and 41 patients in the traditional treatment group. All the patients were followed up with a median of 17.5 months. One patient in the observation group had an infection on the reconstructed side 3 weeks after surgery, and the implant was retained after 2 weeks of conservative treatment such as antibiotics. Two patients in the prosthesis implantation group were not satisfied with size of the reconstructed breast was smaller than the opposite side. In the traditional treatment group, there were 3 cases of postoperative infection or delayed wound healing, and 26 cases of postoperative breast asymmetry.

CONCLUSIONS

For patients with MGLM, it is safe to select stage I prosthesis implantation after conservative treatment, with exact effect and high patient satisfaction.

摘要

背景

肉芽肿性小叶性乳腺炎(GLM)是一种慢性良性炎性乳腺疾病,临床上主要表现为肿块样肉芽肿性小叶性乳腺炎(MGLM)。关于I期植入物乳房重建在GLM中的应用报道较少。本观察性研究旨在评估I期植入物乳房重建治疗MGLM的安全性和有效性。

方法

选取2019年4月至2020年6月在我院就诊的MGLM患者,根据磁共振成像(MRI)检查进行分级。MGLM患者根据其意愿分为假体植入组和传统治疗组。分析两组手术前后的临床参数,观察术后感染、复发情况以及外观和美学满意度,以评估植入物乳房重建治疗MGLM的安全性和有效性。

结果

共有59例MGLM患者,其中3 - 4级GLM患者31例(双侧异时性GLM患者11例)。假体植入组18例患者,包括双侧异时性GLM患者9例、同步性GLM患者2例,传统治疗组41例患者。所有患者均接受随访,中位随访时间为17.5个月。观察组1例患者术后3周重建侧发生感染;经抗生素等保守治疗2周后保留了植入物。假体植入组有2例患者对重建乳房尺寸小于对侧不满意。传统治疗组有3例患者术后发生感染或伤口延迟愈合,26例患者术后出现乳房不对称。

结论

对于MGLM患者,保守治疗后选择I期假体植入是安全的,效果确切,患者满意度高。

相似文献

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Pathological manifestations of granulomatous lobular mastitis.肉芽肿性小叶性乳腺炎的病理表现。
Front Med (Lausanne). 2024 Feb 2;11:1326587. doi: 10.3389/fmed.2024.1326587. eCollection 2024.

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