Reid Angus, Sibbering Lewis, Burridge Isabel, Kalra Loraine, Critchley Adam, Thomas Robert, Pieri Andrew, Carter Jane, O'Donoghue J M, Taylor Guy, Fairhurst Katherine, Cain Henry
Royal Victoria Infirmary & University of Newcastle, Newcastle Upon Tyne, United Kingdom.
Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
Eur J Surg Oncol. 2025 Sep 2;51(11):110430. doi: 10.1016/j.ejso.2025.110430.
Partial breast reconstruction (PBR) using chest wall perforator flaps (CWPFs) is an oncoplastic technique utilised to facilitate breast conservation surgery (BCS). It is particularly applicable in women with a larger tumour-to-breast volume ratio requiring volume replacement rather than volume displacement. This single-centre retrospective cohort study aimed to explore the safety and efficacy of PBR using CWPFs.
All patients who underwent PBR using a CWPF following wide local excision between March 2016 and August 2024 were reviewed. Data was extracted from hospital electronic patient records and statistical analysis performed using R-Studio® (alpha = 0.05).
Of 290 cases identified: 237 had invasive cancers and 53 ductal carcinoma in situ (DCIS). The median age at presentation was 59 years and the median tumour size 22 mm, with multifocal tumours in 22.1 % of cases and extensive DCIS in 27.0 % of invasive cancers. Overall, complication rates were low (n = 83, 28.6 %) with 6.9 % of patients requiring a return to theatre. Margins were involved in 17.8 %, with 15.6 % requiring re-excision. The locoregional recurrence (LRR) rate was 2.9 % and disease-free survival (DFS) 93.8 % with a median follow-up of 3.1 years (n = 276). A subset analysis of women receiving surgery before January 2020 (n = 96) with a follow-up of 5.1 years had a LRR of 4.2 %.
This study reports acceptable rates of complications, margin re-excision and LRR, demonstrating the safety and efficacy of utilising PBR with CWPFs for the treatment of breast cancer. CWPFs offer the opportunity to extend the boundaries of BCS to those women who may otherwise require a mastectomy.
使用胸壁穿支皮瓣（CWPF）进行部分乳房重建（PBR）是一种肿瘤整形技术，用于促进保乳手术（BCS）。它特别适用于肿瘤与乳房体积比更大、需要进行体积替代而非体积移位的女性。这项单中心回顾性队列研究旨在探讨使用CWPF进行PBR的安全性和有效性。
对2016年3月至2024年8月期间在广泛局部切除术后使用CWPF进行PBR的所有患者进行了回顾。数据从医院电子病历中提取，并使用R-Studio®进行统计分析（α = 0.05）。
在290例病例中：237例为浸润性癌，53例为原位导管癌（DCIS）。就诊时的中位年龄为59岁，中位肿瘤大小为22 mm，22.1%的病例有多灶性肿瘤，27.0%的浸润性癌有广泛的DCIS。总体而言，并发症发生率较低（n = 83，28.6%），6.9%的患者需要再次手术。切缘受累率为17.8%，15.6%的患者需要再次切除。局部区域复发（LRR）率为2.9%，无病生存率（DFS）为93.8%，中位随访时间为3.1年（n = 276）。对2020年1月前接受手术的女性（n = 96）进行的亚组分析，随访5.1年，LRR为4.2%。
本研究报告了可接受的并发症、切缘再次切除和LRR发生率，证明了使用PBR联合CWPF治疗乳腺癌的安全性和有效性。CWPF为将BCS的范围扩大到那些否则可能需要乳房切除术的女性提供了机会。
