Yu Monica, Mahoney Mary-Helen, Soon Gordon, Pinchuk Brian, Somogyi Ron
University of Toronto, Division of Plastic and Reconstructive Surgery.
North York General Hospital, Toronto, Ontario, Canada.
JPRAS Open. 2021 Oct 29;31:50-61. doi: 10.1016/j.jpra.2021.10.007. eCollection 2022 Mar.
Pre-operative estimation of breast mound volume for immediate breast reconstruction is necessary for operative planning, especially in direct-to-implant reconstruction. Our purpose was to investigate the relationship between pre-operative predictions of breast mound weight from 3D imaging and actual mastectomy weight and implant size.
A retrospective chart review of all patients who had previously undergone nipple-sparing mastectomy (NSM) by a single surgeon was performed. Pre-operative 3D images were reviewed and calculations of breast mound weight were performed by three independent reviewers. Intra-operative mastectomy weight and final implant weight were collected from patient charts. A regression analysis between calculated and actual values was performed.
There were 59 reconstructed breasts included. Pre-operative 3D imaging-guided breast weight calculations were similar across reviewers (R=0.96). Pre-operative calculations of breast weight were 49.4g (SD=134.0) smaller than actual mastectomy specimens. Mastectomy specimens were 41.0g (SD=130.2) smaller than final implant sizes. Thereby, the relationship was as follows: Pre-operative calculated breast weight < actual Mastectomy weight < implant weight. Mastectomy weight and final implant size had linear relationships with pre-operative calculations of breast weight. Formulas for predicting mastectomy weight [mastectomy weight = 63.2 + 0.95 (pre-operative calculated weight)] and implant size [Implant weight = 209.7+ 0.56 (pre-operative calculated weight)] from pre-operative calculations of breast weight were generated.
Three-dimensional scanning technologies may be a useful tool to predict implant sizes for direct-to-implant breast reconstruction. Final implant size was heavier than intra-operative mastectomy weight and pre-operative calculated breast mound weight.
对于即刻乳房重建，术前估计乳房体积对于手术规划是必要的，尤其是在直接植入式重建中。我们的目的是研究通过三维成像对乳房重量进行术前预测与实际乳房切除术重量及植入物尺寸之间的关系。
对由单一外科医生先前实施保留乳头的乳房切除术（NSM）的所有患者进行回顾性病历审查。回顾术前三维图像，并由三名独立审查员进行乳房重量计算。从患者病历中收集术中乳房切除术重量和最终植入物重量。对计算值和实际值进行回归分析。
纳入59个重建乳房。各审查员之间术前三维成像引导下的乳房重量计算结果相似（R = 0.96）。术前乳房重量计算值比实际乳房切除标本轻49.4g（标准差 = 134.0）。乳房切除标本比最终植入物尺寸轻41.0g（标准差 = 130.2）。因此，关系如下：术前计算的乳房重量＜实际乳房切除重量＜植入物重量。乳房切除重量和最终植入物尺寸与术前乳房重量计算值呈线性关系。得出了根据术前乳房重量计算值预测乳房切除重量[乳房切除重量 = 63.2 + 0.95（术前计算重量）]和植入物尺寸[植入物重量 = 209.7 + 0.56（术前计算重量）]的公式。
三维扫描技术可能是预测直接植入式乳房重建植入物尺寸的有用工具。最终植入物尺寸比术中乳房切除重量和术前计算的乳房体积重量更重。
