Pawlak Natalie, Karamchandani Manish, Wareham Carly, Gaffney Kerry, Zaccardelli Alessandra, Nardello Salvatore, Persing Sarah, Chatterjee Abhishek, Homsy Christopher
Tufts University School of Medicine, Boston, Massachusetts, USA.
Department of Surgery, Tufts Medical Center, Boston, Massachusetts, USA.
J Surg Oncol. 2022 Nov;126(6):956-961. doi: 10.1002/jso.27009. Epub 2022 Jul 8.
Oncoplastic breast reduction mammoplasty (ORM) is an excellent treatment option for women with breast cancer and macromastia undergoing breast conservation therapy. Here, we aim to better understand the risks associated with ORM compared to standard reduction mammoplasty (SRM).
A retrospective chart review was performed of patients undergoing ORM or SRM from 2015 to 2021. Primary outcomes included the occurrence of major or minor postoperative complications in the two groups and delays to adjuvant therapy (>90 days) among the women undergoing ORM.
Women in the ORM group (n = 198) were significantly older (p < 0.001) with a higher prevalence of smoking (p < 0.001), diabetes mellitus (p < 0.01), and a Charlson comorbidity index ≥ 3 (p < 0.001) compared to women undergoing SRM (n = 177). After controlling for potential confounders, there were no significant between-group differences in the odds of developing postoperative complications (odds ratio = 0.80, 95% confidence interval: 0.36-1.69). Only 3% (n = 4) of the 150 women undergoing adjuvant radiation or chemotherapy experienced delays related to postoperative complications.
ORM has a similar safety profile as SRM, despite the older age and higher number of comorbidities often seen in patients undergoing ORM, and is a safe option for achieving contralateral symmetry at the time of partial mastectomy without delays to adjuvant therapy.
肿瘤整形性乳房缩小成形术(ORM)是乳腺癌合并巨乳症且正在接受保乳治疗的女性的一种极佳治疗选择。在此,我们旨在更好地了解与标准乳房缩小成形术(SRM)相比,ORM相关的风险。
对2015年至2021年接受ORM或SRM的患者进行回顾性病历审查。主要结局包括两组术后主要或次要并发症的发生情况,以及接受ORM的女性辅助治疗延迟(>90天)情况。
与接受SRM的女性(n = 177)相比,ORM组(n = 198)的女性年龄显著更大(p < 0.001),吸烟(p < 0.001)、糖尿病(p < 0.01)患病率更高,且Charlson合并症指数≥3(p < 0.001)。在控制潜在混杂因素后,两组术后发生并发症的几率无显著组间差异(优势比 = 0.80,95%置信区间:0.36 - 1.69)。在150名接受辅助放疗或化疗的女性中,只有3%(n = 4)因术后并发症出现治疗延迟。
尽管接受ORM的患者通常年龄较大且合并症较多,但ORM与SRM具有相似的安全性,并且是在保乳手术时实现对侧对称且不延迟辅助治疗的安全选择。