From the Department of Plastic and Reconstructive Surgery, Miami Cancer Institute at Baptist Health South Florida, Miami, FL.
Division of Plastic Surgery, Department of Surgery, Florida International University Herbert Wertheim College of Medicine, Miami, FL.
Ann Plast Surg. 2023 Jan 1;90(1):33-40. doi: 10.1097/SAP.0000000000003386.
Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results and cancer outcomes in the treatment of patients with macromastia or significant ptosis. This study evaluated a series of patients undergoing breast conservation with concomitant oncoplastic-augmentation-mastopexy and a contralateral augmentation-mastopexy.
Patients undergoing lumpectomy for breast conservation were identified via a retrospective chart review. Inclusion criteria included patients with ptosis and preexisting breast implants or insufficient breast volume undergoing oncoplastic implant placement/exchange and mastopexy. Demographic characteristics, operative details, and complications were assessed.
Thirty-four consecutive patients (64 breasts, 4 unilateral procedures) were included in the study. Average age was 51.4 years, average body mass index was 27, and 38.2% were smokers/former smokers. The average operative time was 2.5 hours. Furthermore, 38.2% of patients received chemotherapy, and 82.4% of patients received breast adjuvant radiotherapy. The average length of follow-up was 11.7 months. In the sample that received radiation, the capsular contracture rate was 25%, with a 7.1% contracture revision rate. For the entire group, a total of 8 patients (23.5%) underwent revisions for either positive margins (8.8%), capsular contracture (8.8%), implant loss (2.9%), or cosmetic concerns (2.9%). One patient developed a pulmonary embolism.
Oncoplastic-augmentation-mastopexy is a safe technique with acceptable complication rates. This technique is best used for breast cancer patients with breast ptosis and a paucity of breast volume or preexisting implants who wish to pursue breast-conserving therapy. The revision rates are acceptable compared with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature, but patients must be clearly counseled on contracture risk.
保乳手术联合肿瘤整形技术，已被证实能为巨乳症或严重乳房下垂患者的治疗带来良好的美容效果和癌症治疗效果。本研究评估了一系列接受保乳手术联合肿瘤整形-隆乳-乳房悬吊术和对侧隆乳-乳房悬吊术的患者。
通过回顾性病历分析，确定接受保乳术的患者。纳入标准包括乳房下垂且存在乳房假体或乳房体积不足的患者，需行肿瘤整形假体植入/更换和乳房悬吊术。评估了患者的人口统计学特征、手术细节和并发症。
研究共纳入 34 例连续患者（64 侧乳房，4 例单侧手术）。平均年龄为 51.4 岁，平均 BMI 为 27，38.2%为吸烟者/曾经吸烟者。平均手术时间为 2.5 小时。此外，38.2%的患者接受了化疗，82.4%的患者接受了乳房辅助放疗。平均随访时间为 11.7 个月。在接受放疗的样本中，包膜挛缩率为 25%，挛缩修复率为 7.1%。对于整个组，共有 8 例患者（23.5%）因阳性切缘（8.8%）、包膜挛缩（8.8%）、假体丢失（2.9%）或美容问题（2.9%）而接受了修复。1 例患者发生肺栓塞。
肿瘤整形-隆乳-乳房悬吊术是一种安全的技术，并发症发生率可接受。该技术最适用于乳房下垂且乳房体积不足或存在乳房假体的乳腺癌患者，这些患者希望接受保乳治疗。与单阶段美容隆乳术以及文献中描述的其他肿瘤整形技术相比，修复率是可以接受的，但必须向患者明确告知挛缩风险。
