Monib Sherif, Elzayat Ibrahim
Breast Surgery, West Hertfordshire Hospitals National Health Services (NHS) Trust, St. Albans and Watford General Hospitals, London, GBR.
General Surgery, Aswan University Hospital, Aswan, EGY.
Cureus. 2021 Nov 3;13(11):e19226. doi: 10.7759/cureus.19226. eCollection 2021 Nov.
Background With recent advances in different breast cancer treatment modalities, breast conservation surgery (BCS) has gained popularity and has become the mainstay for the treatment of early breast cancer. The model of dedicated breast surgeons working in breast units is standard in some but not all countries. We have aimed to define surgical outcomes of oncoplastic breast surgery carried out by one general surgical oncologist. Patients and methods We have conducted a prospective non-randomised case series analysis to assess the oncologic and aesthetic outcome of tissue displacement oncoplastic breast techniques in managing unifocal early-stage breast cancer from January 2019 to January 2020. One surgical oncologist with 23 years of surgical oncology experience carried out all operations. Results We have included 50 female patients treated with variant oncoplastic volume displacement techniques. We have used the round block technique in 20%, the batwing technique in 18%, lateral mammoplasty in 20%, and medial mammoplasty in 2%. We have also carried out wise pattern therapeutic mammoplasty with inferior pedicle in 20% (10 patients), and vertical mammoplasty with superior pedicle in 20% (10 patients). While 8% of our patients had Clavien-Dindo system grade I Immediate complications, including the surgical site infection and postoperative seroma and haematoma, 2% of patients had grade II complications in the form of partial areola and nipple complex necrosis leading to delayed wound healing requiring secondary suturing. No delayed complications or mortalities were recorded. Eight per cent of patients required re-excision to clear margins, 74% had excellent results, 24% had good results, and 2% had fair results. In addition, 64% were very satisfied with their results, 32% were satisfied, while 4% were not satisfied with aesthetic results. Conclusion Based on our limited number of patients, we have found that tissue displacement oncoplastic techniques carried out by a general surgical oncologist are safe and reliable in providing satisfactory oncological outcomes with a low risk of delaying adjuvant therapy and acceptable aesthetic outcomes.
背景 随着不同乳腺癌治疗方式的最新进展，保乳手术（BCS）已越来越受欢迎，并已成为早期乳腺癌治疗的主要手段。在乳腺专科工作的专业乳腺外科医生模式在一些国家是标准模式，但并非所有国家都是如此。我们旨在确定由一位普通外科肿瘤学家实施的肿瘤整形乳房手术的手术效果。
患者与方法 我们进行了一项前瞻性非随机病例系列分析，以评估2019年1月至2020年1月期间组织移位肿瘤整形乳房技术在治疗单灶性早期乳腺癌中的肿瘤学和美学效果。一位拥有23年外科肿瘤学经验的外科肿瘤学家实施了所有手术。
结果 我们纳入了50例接受不同肿瘤整形体积移位技术治疗的女性患者。我们使用了圆形块技术的占20%，蝙蝠翼技术的占18%，外侧乳房成形术的占20%，内侧乳房成形术的占2%。我们还实施了带下方蒂的改良根治性乳房成形术的占20%（10例患者），以及带上方蒂的垂直乳房成形术的占20%（10例患者）。我们8%的患者出现了Clavien-Dindo系统I级即刻并发症，包括手术部位感染、术后血清肿和血肿，2%的患者出现了II级并发症，表现为部分乳晕和乳头复合体坏死，导致伤口愈合延迟，需要二次缝合。未记录到延迟并发症或死亡病例。8%的患者需要再次切除以切缘阴性，74%的患者效果极佳，24%的患者效果良好，2%的患者效果尚可。此外，64%的患者对其结果非常满意，32%的患者满意，而4%的患者对美学效果不满意。
结论 基于我们有限的患者数量，我们发现由普通外科肿瘤学家实施的组织移位肿瘤整形技术在提供令人满意的肿瘤学效果、延迟辅助治疗风险低以及美学效果可接受方面是安全可靠的。
