Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, 920-0293, Japan.
Breast Center, Kanazawa Medical University Hospital, Daigaku 1-1, Uchinada-Kahoku, Ishikawa, Japan.
Surg Today. 2024 Jan;54(1):14-22. doi: 10.1007/s00595-023-02690-0. Epub 2023 May 8.
Breast deformity occurring in the lower pole after breast conserving surgery (BCS) is known as bird's beak (BB) deformity. This retrospective study evaluated the outcomes in breasts reconstructed with a conventional closing procedure (CCP) and a downward-moving procedure (DMP), respectively, after BCS.
In CCP, the inferomedial and inferolateral portions of breast tissues were reapproximated toward the midline after wide excision to repair the breast defect. In DMP, the retro-areolar breast tissue was detached from the nipple-areolar complex after wide excision, and the upper pole breast tissue was moved downward to refill the breast defect.
CCP was performed in 20 patients (Group A), and DMP was performed in 28 patients (Group B). Although retraction of the lower part of the breast was postoperatively observed in 13 (72%) of 18 patients from Group A, it was observed in 7 (28%) of 25 patients in Group B (p < 0.05). The downward pointing of the nipple was observed in 8 (44%) of 18 patients from Group A and in 4 (16%) of 25 patients in Group B (p < 0.05).
DMP is more useful for preventing BB deformity than CCP.
保乳手术后乳房下极出现的畸形称为鸟嘴畸形。本回顾性研究分别评估了保乳手术后采用传统闭合术(CCP)和向下移动术(DMP)进行乳房重建的效果。
在 CCP 中,广泛切除后,将乳房的内下和内下部分重新向中线靠拢,以修复乳房缺陷。在 DMP 中,广泛切除后,从乳头乳晕复合体分离乳晕后乳房组织,将上极乳房组织向下移动以填充乳房缺陷。
20 例患者采用 CCP(A 组),28 例患者采用 DMP(B 组)。尽管 A 组 18 例患者中有 13 例(72%)术后观察到乳房下部回缩,但 B 组 25 例患者中有 7 例(28%)观察到(p<0.05)。A 组 18 例患者中有 8 例(44%)乳头向下指向,B 组 25 例患者中有 4 例(16%)乳头向下指向(p<0.05)。
与 CCP 相比,DMP 更有助于预防鸟嘴畸形。