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内侧乳腺癌保乳重建的手术策略:12年经验

Surgical Strategies for Partial Breast Reconstruction in Medial-Located Breast Cancer: A 12-Year Experience.

作者信息

Kang Myeong Jae, Hong Hyun Ki, Eo Pil Seon, Lee Joon Seok, Lee Jeong Woo, Lee Jeeyeon, Park Ho Yong, Yang Jung Dug

机构信息

Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

出版信息

J Breast Cancer. 2023 Feb;26(1):35-45. doi: 10.4048/jbc.2023.26.e8.

Abstract

PURPOSE

Partial breast reconstruction is challenging in medially located breast cancer, particularly in terms of achieving satisfactory aesthetic coverage. Thus, we aimed to investigate surgical strategies for filling medial defects resulting from breast-conserving surgery to improve patient satisfaction and aesthetic outcomes.

METHODS

We retrospectively evaluated 113 patients (114 cases) with medially located breast cancer between 2007 and 2018. We analysed the patient data, such as breast size, specimen weight, complications, and aesthetic results obtained using a questionnaire.

RESULTS

The mean body mass index and specimen weight were 23.43 kg/m² (range, 18.5-26.8) and 83.29 g (range, 15-290 g), respectively. The tennis racket and round-block techniques were chosen for small defects (< 10%-15%) in small- and medium-sized breasts. The rotational and perforator flap techniques were used for medium-sized defects. The latissimus dorsi (LD) flap technique was used for large defects (> 30%). Hematoma was found in 1 case (0.96%), linear skin necrosis was found in 1 case (0.96%), seroma in the LD flaps was found in 8 cases (7.69%); fat necrosis in the rotational flaps was found in 2 cases (1.92%); and fat necrosis in an anterior intercostal artery perforator flap was found in 1 case (0.96%). 91 patients (87.5%) were satisfied with the aesthetic results.

CONCLUSION

The techniques used in this study for medially located breast cancer can produce fine aesthetic outcomes with regard to breast size and resection volume, with few complications.

摘要

目的

对于位于乳腺内侧的乳腺癌,进行部分乳房重建具有挑战性,尤其是在实现令人满意的美学覆盖方面。因此,我们旨在研究用于填充保乳手术后内侧缺损的手术策略,以提高患者满意度和美学效果。

方法

我们回顾性评估了2007年至2018年间113例(114侧)乳腺内侧癌患者。我们分析了患者数据,如乳房大小、标本重量、并发症以及使用问卷获得的美学结果。

结果

平均体重指数和标本重量分别为23.43kg/m²(范围18.5 - 26.8)和83.29g(范围15 - 290g)。对于中小乳房中的小缺损(<10% - 15%),选择了网球拍技术和圆形块状技术。对于中等大小的缺损,采用了旋转皮瓣和穿支皮瓣技术。背阔肌(LD)皮瓣技术用于大缺损(>30%)。1例(0.96%)出现血肿,1例(0.96%)出现线性皮肤坏死,8例(7.69%)的LD皮瓣出现血清肿;2例(1.92%)的旋转皮瓣出现脂肪坏死;1例(0.96%)的肋间前动脉穿支皮瓣出现脂肪坏死。91例(87.5%)患者对美学效果满意。

结论

本研究中用于乳腺内侧癌的技术在乳房大小和切除体积方面可产生良好的美学效果,且并发症较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e50/9981984/4adc24f81407/jbc-26-35-g001.jpg

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