Soh Chien Lin, Asher Christian M, Forouhi Parto, Moyle Penelope, Healy Nuala Ann, Malata Charles M
University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK.
Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK.
J Surg Case Rep. 2022 Oct 10;2022(10):rjac432. doi: 10.1093/jscr/rjac432. eCollection 2022 Oct.
It is well reported that patients who have undergone breast augmentation and subsequently develop breast cancer can successfully undergo breast-conserving therapy with preservation of their implants. However, there is a paucity of literature on the radiological investigations and surgical techniques in postmastectomy implant-reconstructed patients who develop recurrences to enable preservation of their implant-based reconstruction whilst effectively treating the local recurrence. The wide adoption of acellular dermal matrix use in prosthetic breast reconstruction in recent years has made radiological evaluation of such patients challenging. Herein presented is a case of a 37-year-old woman where wide local excision of a local recurrence abutting a peri-implant capsule following previous mastectomy and implant-acellular dermal matrix (ADM) reconstruction was performed with successful preservation of reconstruction volume (and shape) using an ADM patch to repair the capsular defect whilst retaining the implant Radiological investigation facilitated and guided the surgical planning and oncological clearance.
有充分报道称，接受过隆胸手术且随后患乳腺癌的患者能够成功接受保乳治疗并保留其植入物。然而，关于乳房切除术后植入物重建的患者出现复发时的放射学检查和手术技术的文献却很匮乏，这些技术能够在有效治疗局部复发的同时保留基于植入物的重建。近年来，脱细胞真皮基质在假体乳房重建中的广泛应用使得对此类患者的放射学评估具有挑战性。本文介绍了一例37岁女性的病例，该患者在先前乳房切除术后进行了植入物 - 脱细胞真皮基质（ADM）重建，对紧邻植入物周围包膜的局部复发灶进行了广泛局部切除，手术成功保留了重建体积（和形状），使用ADM补片修复包膜缺损并保留了植入物。放射学检查为手术规划和肿瘤清除提供了便利并起到了指导作用。
