Berrino P, Campora E, Santi P
Plast Reconstr Surg. 1987 Apr;79(4):567-72.
The deformity which is encountered following quadrantectomy (or similar procedures such as segmentectomy or partial mastectomy) and radiation therapy is difficult to evaluate objectively, and subjective assessment of the cosmetic outcome is extremely variable. In a group of 54 patients who underwent the procedure between 1979 and 1983, the types of cosmetic changes were evaluated and classified according to morphologic criteria. Four types of deformities and their related etiopathologic factors were identified. Type I is characterized by malposition and distortion of the nipple-areola complex and is mainly due to postoperative fibrosis and scar contracture. In type II deformity, localized tissue insufficiency is observed, which may be due to skin deficiency (type IIa), subcutaneous tissue deficiency (type IIb), or both (type IIab). Type III deformity is characterized by breast retraction and shrinkage and is mainly due to the effects of radiotherapy on residual breast parenchyma. In type IV deformity, severe radiation-induced damage to the skin, nipple-areola complex, and subcutaneous and glandular tissues is present. Surgical correction of each type of deformity is discussed, and examples are reported.
象限切除术（或类似手术，如节段切除术或部分乳房切除术）及放射治疗后出现的畸形难以进行客观评估，且对美容效果的主观评价差异极大。在1979年至1983年间接受该手术的54例患者中，根据形态学标准对美容改变的类型进行了评估和分类。确定了四种类型的畸形及其相关的病因学因素。I型以乳头乳晕复合体的位置异常和变形为特征，主要是由于术后纤维化和瘢痕挛缩所致。在II型畸形中，观察到局部组织不足，这可能是由于皮肤缺损（IIa型）、皮下组织缺损（IIb型）或两者皆有（IIab型）。III型畸形的特征是乳房回缩和缩小，主要是由于放疗对残留乳腺实质的影响。在IV型畸形中，存在严重的放射性皮肤、乳头乳晕复合体、皮下及腺体组织损伤。文中讨论了每种类型畸形的手术矫正方法，并报告了实例。
