Zingaretti Nicola, Miotti Giovanni, Maronese Carlo Alberto, Isola Miriam, Guarneri Gianni Franco, Albanese Roberta, De Francesco Francesco, Riccio Michele, Cereser Lorenzo, Zuiani Chiara, Parodi Pier Camillo
Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, Department of Medical Area (DAME), University of Udine, 33100 Udine, Italy.
Accademia del Lipofilling, Research and Training Center in Regenerative Surgery, 61025 Montelabbate, Italy.
J Clin Med. 2021 Nov 9;10(22):5216. doi: 10.3390/jcm10225216.
Preoperative breast volume estimation is very important for the success of the breast surgery. In this study four different breast volume determination methods were compared. The end-point of this prospective study was to evaluate the concordance between different modalities of breast volume assessment (MRI, BREAST-V, mastectomy specimen weight, conversion from weight to volume of mastectomy specimen) and the breast prosthetic volume implanted. The study enrolled 64 patients between 2017 and 2019, who had all been treated by the same surgeons for monolateral nipple-areola complex-sparing mastectomy and implant breast reconstruction. Only patients who had a breast reconstruction classified as "excellent" from an objective (BCCT.core software) and subjective (questionnaire) point of view at the 6-month interval after the operation were included in the study. Data analysis highlighted a strong correlation between the volumes of the chosen prostheses and the weights of mastectomy converted into volume, especially for patients with grades B and C parenchymal density. The values of the agreement between the volumes of the chosen prostheses and the assessments from MRI and BREAST -V proved to be lower than expected from the literature. None of the four studied methods presented any strong correlation with the initial breast width. Our results suggest that conversion from weight to volume of mastectomy specimen should be used to assist in determining the volume of the breast implant to be implanted. This method would help the reconstructive surgeon guide the choice of the most appropriate implant preoperatively.
术前乳房体积估计对乳房手术的成功至关重要。在本研究中，对四种不同的乳房体积测定方法进行了比较。这项前瞻性研究的终点是评估不同乳房体积评估方式（MRI、BREAST-V、乳房切除标本重量、乳房切除标本重量到体积的转换）与植入的乳房假体体积之间的一致性。该研究纳入了2017年至2019年间的64例患者，这些患者均由同一组外科医生进行了单侧乳头乳晕复合体保留乳房切除术和植入式乳房重建。只有那些在术后6个月间隔时从客观（BCCT.core软件）和主观（问卷调查）角度被归类为“优秀”的乳房重建患者被纳入研究。数据分析突出显示了所选假体的体积与转换为体积的乳房切除标本重量之间存在很强的相关性，尤其是对于实质密度为B级和C级的患者。所选假体体积与MRI和BREAST-V评估之间的一致性值低于文献预期。所研究的四种方法中没有一种与初始乳房宽度有很强的相关性。我们的结果表明，应使用乳房切除标本重量到体积的转换来辅助确定要植入的乳房假体的体积。这种方法将有助于重建外科医生在术前指导选择最合适的假体。
