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保留乳头的乳房切除术联合即刻假体植入乳房重建术治疗单纯乳腺导管原位癌患者。

Nipple-sparing Mastectomy with Immediate Implant-based Reconstruction for Patients with Pure Ductal Carcinoma in Situ.

机构信息

Mastology Service, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2022 Apr;44(4):376-384. doi: 10.1055/s-0042-1742315. Epub 2022 May 27.

Abstract

OBJECTIVE

The presence of an extensive intraductal component is associated to an increasing risk of relapse in the nipple-areola complex. The aim of the present study was to evaluate the outcomes of patients diagnosed with ductal carcinoma in situ (DCIS) who underwent nipple-sparing mastectomy (NSM) with immediate breast reconstruction using silicone implants.

METHODS

We retrospectively analyzed the postoperative complications and oncological safety of 67 breast cancer patients diagnosed with pure DCIS who underwent NSM with immediate breast reconstruction using silicone implants between 2004 and 2018.

RESULTS

Among the 127 NSM procedures performed, 2 hematomas (1.5%) and 1 partial nipple necrosis (0.7%) were observed. After a mean follow-up of 60 months, the local recurrence rate was of 8.9%, the disease-free survival rate was of 90%, and 1 of the patients died.

CONCLUSION

Despite the local recurrence rate, we showed that NSM with immediate breast reconstruction using silicone implants is a feasible surgical approach, with a low rate of complications and high survival rates for patients with a diagnosis of pure DCIS when breast-conserving surgery is not an option.

摘要

目的

广泛的导管内成分的存在与乳头乳晕复合体复发风险的增加相关。本研究的目的是评估诊断为导管原位癌(DCIS)并接受保留乳头的乳房切除术(NSM)联合即刻硅胶假体乳房重建的患者的结局。

方法

我们回顾性分析了 2004 年至 2018 年间接受 NSM 联合即刻硅胶假体乳房重建的 67 例单纯 DCIS 患者的术后并发症和肿瘤安全性。

结果

在 127 例 NSM 手术中,观察到 2 例血肿(1.5%)和 1 例部分乳头坏死(0.7%)。平均随访 60 个月后,局部复发率为 8.9%,无病生存率为 90%,1 例患者死亡。

结论

尽管存在局部复发率,但我们表明,对于不能行保乳手术的单纯 DCIS 患者,NSM 联合即刻硅胶假体乳房重建是一种可行的手术方法,并发症发生率低,生存率高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcae/9948099/4d1ec53a2730/10-1055-s-0042-1742315-i210158-1.jpg

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