Athamnah Mohammad, Rabai Nimah A, Shkoukani Zakaria W, Al Azzam Hussein S, Abu-Shanab Amer
Department of General Surgery, Princess Basma Teaching Hospital, Irbid, JOR.
Department of General Surgery, Aberdeen Royal Infirmary, Scotland, GBR.
Cureus. 2021 Nov 3;13(11):e19238. doi: 10.7759/cureus.19238. eCollection 2021 Nov.
Introduction Nipple-sparing mastectomy (NSM), a procedure involving careful dissection of the breast tissue whilst keeping the nipple-areola complex (NAC) intact, is now increasingly practiced amongst surgeons in the treatment of certain situations of breast cancer. Given the importance of breasts to the female body image, this type of conservative breast surgery takes into account patient satisfaction and overall cosmesis, whilst ensuring appropriate oncological safety. Methods and results Four nipple-sparing mastectomy procedures were performed in our tertiary care centre, Princess Basma Teaching Hospital, in Jordan between June and September 2019. Indications for these procedures included invasive ductal carcinoma, malignant phyllodes, and high-grade ductal carcinoma in-situ. Patients were carefully assessed prior to surgical intervention using radiological imaging, ensuring a distance from NAC of >2 cm in all cases. Procedures were performed successfully with minimal intraoperative and no post-operative complications. Follow-up was carried out at 24 months, with no cases of local or distant post-operative recurrence, and patient satisfaction was qualitatively measured with the use of a BREAST-Q questionnaire. The questionnaire demonstrated improved overall physical well-being and satisfaction with an average overall post-operative physical well-being of 97%. Conclusion Following nipple-sparing mastectomy and immediate submuscular reconstruction with silicone implants,patients demonstrated high levels of satisfaction and quality of life (QoL) as measured by BREAST-Q survey. Two years of follow-up confirmed high patient satisfaction with increased scores from the preoperative baseline level.
引言
保乳手术(NSM)是一种在保留乳头乳晕复合体(NAC)完整的同时仔细切除乳腺组织的手术,目前在治疗某些乳腺癌情况时,越来越多的外科医生采用这种手术。鉴于乳房对女性身体形象的重要性,这种保守性乳房手术在确保适当肿瘤学安全性的同时,考虑到了患者满意度和整体美容效果。
方法与结果
2019年6月至9月期间,我们在约旦的三级护理中心——公主巴斯玛教学医院进行了4例保乳手术。这些手术的适应症包括浸润性导管癌、恶性叶状肿瘤和高级别导管原位癌。在手术干预前,通过放射影像学对患者进行了仔细评估,确保所有病例中肿瘤距NAC的距离>2 cm。手术成功完成,术中出血量极少,且无术后并发症。术后24个月进行随访,无局部或远处术后复发病例,并使用BREAST-Q问卷对患者满意度进行了定性测量。问卷显示患者整体身体健康状况有所改善,术后平均整体身体健康满意度为97%。
结论
通过BREAST-Q调查测量,保乳手术联合即刻肌下硅胶植入重建术后,患者表现出较高的满意度和生活质量(QoL)。两年的随访证实患者满意度较高,得分较术前基线水平有所提高。