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保乳术治疗乳腺癌的肿瘤学和外科手术疗效:单中心回顾性研究。

Oncological and Surgical Outcomes of Oncoplastic Reduction Mammoplasty: A Single-centre Retrospective Study.

机构信息

Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, Geneva, Switzerland.

Department of Gynecology and Obstretrics, Geneva University Hospitals, Geneva University, Geneva, Switzerland.

出版信息

In Vivo. 2024 Nov-Dec;38(6):2820-2826. doi: 10.21873/invivo.13762.

Abstract

BACKGROUND/AIM: Breast-conserving surgery is the preferred treatment for early-stage breast cancer but can often result in unsatisfactory cosmetic outcomes. Oncoplastic surgery aims to improve both oncologic and aesthetic outcomes by combining local excision with plastic surgery techniques. Using breast reduction techniques in breast cancer treatment has been shown to allow for wider margins of excision, leading to enhanced oncological safety and reduced recurrence rates without causing significant asymmetry. This study aimed to analyze the surgical and oncological outcomes of a large cohort of patients undergoing oncoplastic reduction mammoplasty (ORM).

PATIENTS AND METHODS

A retrospective analysis of postoperative surgical and oncological outcomes of all patients who underwent ORM at a single center between January 2018 and December 2023 was performed. Preoperative patient characteristics, operative and post-operative outcomes were recorded and analyzed.

RESULTS

A total of 67 patients that underwent oncologic breast reduction were included in the final analysis - representing a total of 71 ORM, with a mean (SD) age of 53.1 (10.5) years and a mean (SD) BMI of 28.8 (5.9) kg/m A superomedial pedicle-based technique was the most frequently used (36.6%), followed by inferior pedicle-based technique (28.1%). A complication rate of 18.3% on the ipsilateral side was observed. Salvage surgery was necessary in five cases (7.0%) due to positive margins - with one patient (1.4%) requiring margin expansion surgery and four (5.6%) a completion mastectomy.

CONCLUSION

This monocentric retrospective study shows that ORM is safe, with a complication rate on par with conventional breast reduction and offers satisfactory oncological outcomes.

摘要

背景/目的:保乳手术是早期乳腺癌的首选治疗方法,但往往会导致不满意的美容效果。肿瘤整形手术旨在通过将局部切除与整形手术技术相结合,改善肿瘤学和美容效果。在乳腺癌治疗中使用乳房缩小技术已被证明可以允许更宽的切除边缘,从而提高肿瘤学安全性并降低复发率,而不会导致明显的不对称。本研究旨在分析接受肿瘤整形缩小乳房成形术(ORM)的大量患者的手术和肿瘤学结果。

患者和方法

对 2018 年 1 月至 2023 年 12 月期间在一家中心接受 ORM 的所有患者的术后手术和肿瘤学结果进行了回顾性分析。记录和分析了术前患者特征、手术和术后结果。

结果

共有 67 名接受肿瘤学乳房缩小的患者被纳入最终分析-共进行了 71 例 ORM,平均(SD)年龄为 53.1(10.5)岁,平均(SD)BMI 为 28.8(5.9)kg/m2。最常使用的是基于Superomedial 蒂的技术(36.6%),其次是基于Inferior 蒂的技术(28.1%)。同侧并发症发生率为 18.3%。由于阳性边缘,需要进行挽救性手术的有 5 例(7.0%)-其中 1 例(1.4%)需要进行边缘扩展手术,4 例(5.6%)需要进行全乳房切除术。

结论

这项单中心回顾性研究表明,ORM 是安全的,并发症发生率与常规乳房缩小术相当,并提供令人满意的肿瘤学结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/085f/11535943/3181b2aae76d/in_vivo-38-2821-g0001.jpg

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