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保乳手术的进展——保乳手术中肿瘤整形技术的当前应用:文献综述

Evolution of breast conserving surgery-current implementation of oncoplastic techniques in breast conserving surgery: a literature review.

作者信息

Torras Inés, Cebrecos Isaac, Castillo Helena, Mension Eduard

机构信息

Department of Obstetrics and Gynecology, Hospital Clínic of Barcelona, Barcelona, Spain.

出版信息

Gland Surg. 2024 Mar 27;13(3):412-425. doi: 10.21037/gs-23-454. Epub 2024 Mar 14.

Abstract

BACKGROUND AND OBJECTIVE

De-escalation in breast cancer surgery has been a natural evolution since breast conserving surgery (BCS) was introduced in the early 1980s. From Halsted mastectomies to wide local excisions, we are facing nowadays the next trend in form of oncoplastic breast surgery. Oncoplastic breast surgery combines oncological principles with plastic surgery techniques to preserve the breast shape and appearance. The aim of this work is to review recent oncological and quality of live outcomes derived from oncoplastic techniques as well as offer a perspective about its implementation in breast cancer units.

METHODS

A literature review was conducted to explore the landscape of oncoplastic breast surgery. Key terms related to oncoplastic techniques and breast cancer were used in searches across databases such as PubMed, Embase and Cochrane Library. Inclusion criteria focused on recent articles discussing oncological and quality of life (QoL) outcomes, as well as perspectives on the role of oncoplastic surgery.

KEY CONTENT AND FINDINGS

The research aims to contribute valuable insights into the efficacy and impact of oncoplastic surgery in the context of breast cancer treatment. In this new era of precision medicine, it is more than just healing patients; it is about improving their well-being. We ought to consider specific oncoplasty role in leading this paradigm shift. It is also relevant to define whether these new technical-demanding surgical options can be applied to all patients and if professional training performs adequately to current demands of personalized treatments.

CONCLUSIONS

The global adoption of oncoplastic BCS is recommended due to its oncological safety and improvement in QoL compared to standard procedures. Emphasizing the need for skilled surgeons in complex cases, collaboration between breast surgeons and scientific societies is urged to certify ongoing educational training in oncoplastic techniques.

摘要

背景与目的

自20世纪80年代初引入保乳手术(BCS)以来,乳腺癌手术的降阶梯治疗已成为一种自然的发展趋势。从Halsted乳房切除术到广泛局部切除术,如今我们正面临着肿瘤整形乳房手术形式的下一个趋势。肿瘤整形乳房手术将肿瘤学原则与整形手术技术相结合,以保持乳房的形状和外观。这项工作的目的是回顾近期肿瘤整形技术在肿瘤学和生活质量方面的成果,并就其在乳腺癌治疗单元中的应用提供一个观点。

方法

进行了一项文献综述,以探索肿瘤整形乳房手术的现状。在PubMed、Embase和Cochrane图书馆等数据库中搜索与肿瘤整形技术和乳腺癌相关的关键词。纳入标准集中在近期讨论肿瘤学和生活质量(QoL)结果以及肿瘤整形手术作用的观点的文章。

关键内容与发现

该研究旨在为肿瘤整形手术在乳腺癌治疗背景下的疗效和影响提供有价值的见解。在这个精准医学的新时代,不仅仅是治愈患者;更是关乎改善他们的福祉。我们应该考虑肿瘤整形手术在引领这一范式转变中的具体作用。确定这些新的技术要求高的手术选择是否可以应用于所有患者,以及专业培训是否能充分满足个性化治疗的当前需求也很重要。

结论

由于其肿瘤学安全性以及与标准手术相比生活质量的改善,建议全球采用肿瘤整形保乳手术。强调在复杂病例中需要熟练的外科医生,敦促乳腺外科医生和科学协会之间开展合作,以认证肿瘤整形技术方面正在进行的教育培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c44/11002492/aaa696c35067/gs-13-03-412-f1.jpg

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