Falco Giuseppe, Morando Ljuba, Borgonovo Giulia, Begnini Evelina, Coiro Saverio, Foroni Monica, Cenini Eugenio, Castagnetti Fabio, Mele Simone, Ferrari Guglielmo
Breast Surgery Unit, AUSL IRCCS, Reggio Emilia, Italy.
Plastic And Reconstructive Surgery, AUSL IRCCS, Reggio Emilia, Italy.
Gland Surg. 2024 Aug 31;13(8):1370-1377. doi: 10.21037/gs-24-74. Epub 2024 Aug 27.
For medium/small size breast, breast conserving surgery (BCS) is usually associated to poor cosmetic results. The objective of the study is to evaluate oncological safety and cosmetic results comparing the "Crescent" and the "J" mammoplasty technique and to develop an algorithm for the treatment of breast cancer located in lower quadrants in medium/small breast.
We retrospectively analysed all consecutive patients who underwent a "J" mammoplasty or a "Crescent" technique at AUSL IRCCS Reggio Emilia between 2016 and 2021. Fifty-eight patients were enrolled, the first group including 29 "Crescent" technique procedures and the second one including 29 patients who underwent the "J" mammoplasty technique. Oncological safety and surgical minor and major complications were evaluated. Aesthetic results were evaluated by two senior breast surgeons, independently, at least 6 months after radiotherapy (RT).
At follow-up of 36 months, no recurrences and no major complications were observed in both groups. Minor complications were observed in two (6.9%) "J" group cases and in six (20.7%) "Crescent" ones (P<0.05). The 96.6% of "Crescent" and the 73.5% of "J" cases were judged excellent/good. One (3.4%) "Crescent" was judged fair versus six (20.7%) "J" mammoplasty. Two (6.9%) "J" cases were judged poor, requiring ipsilateral re-operation.
When a favourable ratio between tumor size and breast volume is present, BCS can be performed for tumors located in the lower quadrants. Evaluating patients' anthropometric characteristics, skin involvement and tumor features is the key to select the right technique and to obtain both great cosmetic result and low rate of complications.
对于中/小型乳房，保乳手术（BCS）通常会导致较差的美容效果。本研究的目的是比较“新月形”和“J”形乳房成形术技术，评估肿瘤学安全性和美容效果，并开发一种针对中/小型乳房下象限乳腺癌的治疗算法。
我们回顾性分析了2016年至2021年间在雷焦艾米利亚AUSL IRCCS接受“J”形乳房成形术或“新月形”技术的所有连续患者。共纳入58例患者，第一组包括29例采用“新月形”技术的手术，第二组包括29例接受“J”形乳房成形术技术的患者。评估肿瘤学安全性以及手术的轻微和严重并发症。由两位资深乳腺外科医生在放疗（RT）后至少6个月独立评估美学效果。
在36个月的随访中，两组均未观察到复发和严重并发症。“J”组有2例（6.9%）出现轻微并发症，“新月形”组有6例（20.7%）出现轻微并发症（P<0.05）。“新月形”组96.6%的病例和“J”组73.5%的病例被判定为优/良。1例（3.4%）“新月形”病例被判定为一般，而“J”形乳房成形术有6例（20.7%）。2例（6.9%）“J”组病例被判定为差，需要同侧再次手术。
当肿瘤大小与乳房体积之比有利时，可对位于下象限的肿瘤进行保乳手术。评估患者的人体测量特征、皮肤受累情况和肿瘤特征是选择正确技术并获得良好美容效果和低并发症发生率的关键。
