Department of Breast Surgery, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China.
Nursing Department, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China.
Medicine (Baltimore). 2023 Dec 15;102(50):e36173. doi: 10.1097/MD.0000000000036173.
Breast cancer represents a prevalent malignancy that primarily impacts women, with pronounced consequences on their overarching health. The major therapeutic approach, encompassing surgical procedures, can often culminate in mastectomy, potentially inciting psychological turmoil and disorders.
A patient was admitted to our facility on May 5, 2023, precipitated by the discovery of bilateral breast masses during a routine physical examination conducted 3 days before admission.
The breasts were symmetric, with the right nipple inverted and a palpable mass in the upper outer quadrant of the right breast, measuring approximately 5 cm × 4 cm. The mass was firm with indistinct borders, relatively regular morphology, poor mobility, and no tenderness. Outpatient color Doppler ultrasound revealed heterogeneous echogenicity in the right breast, classified as Breast Imaging Reporting and Data System (BI-RADS) category 0, along with multiple ductal dilatations. The left breast exhibited a hypoechoic area (BI-RADS 3), indicative of proliferative changes. Radiographic mammography confirmed diffuse changes in the right breast (BI-RADS 0) and proliferative signs in the left breast (BI-RADS 2). Biopsy results reveal significant atypical ductal hyperplasia consistent with intermediate-grade ductal carcinoma in situ. This patient was diagnosed as ductal carcinoma in situ of the right breast (cTisN0M0 and Stage 0), accompanied by a left breast mass.
On May 15, 2023, the patient was readmitted for further surgical intervention. Following relevant auxiliary examinations, the patient underwent nipple-areola complex-sparing radical mastectomy for the right breast, sentinel lymph node biopsy in the right axillary area, prosthesis-based breast reconstruction for the right breast, and microrotatotomy of the left breast mass on the left side on May 17.
The patient made a successful recovery under scrupulous perioperative supervision and was discharged 7 days post-surgery.
The axillary approach for endoscopic mammary gland excision and immediate implant reconstruction permits patients to preserve the esthetics of the female form while undergoing conventional medical treatment. This methodology considerably enhances the psychophysical health of the patients, thereby marking it as an advantageous practice worthy of broad dissemination in the medical community.
乳腺癌是一种常见的恶性肿瘤，主要影响女性，对其整体健康有重大影响。主要的治疗方法包括手术，通常最终会导致乳房切除术，可能会引发心理困扰和障碍。
一名患者于 2023 年 5 月 5 日因在入院前 3 天的常规体检中发现双侧乳腺肿块而被收入我院。
双乳对称，右侧乳头内陷，右侧乳房外上象限可触及一肿块，大小约为 5cm×4cm。肿块质硬，边界不清，形态较规则，活动度差，无触痛。门诊彩色多普勒超声显示右侧乳腺不均匀回声，乳腺影像报告和数据系统（BI-RADS）分类为 0 类，同时伴有多个导管扩张。左侧乳腺呈低回声区（BI-RADS 3 类），提示增生性改变。乳腺 X 线摄影证实右侧乳腺弥漫性改变（BI-RADS 0 类）和左侧乳腺增生性征象（BI-RADS 2 类）。活检结果显示右侧乳腺显著非典型导管增生，符合中级别导管原位癌。该患者被诊断为右侧乳腺导管原位癌（cTisN0M0 和 0 期），同时伴有左侧乳腺肿块。
2023 年 5 月 15 日，患者再次入院接受进一步手术治疗。在进行相关辅助检查后，患者于 5 月 17 日在右侧行乳晕复合体保留的根治性乳房切除术、右侧腋窝前哨淋巴结活检、右侧乳房假体再造、左侧乳房肿块微创旋切术。
患者在严格的围手术期监护下康复良好，并于术后 7 天出院。
内镜乳腺切除术和即刻植入物重建的腋窝入路允许患者在接受常规治疗的同时保留女性形态的美观。这种方法极大地提高了患者的身心健康，因此值得在医学界广泛推广。
