Hagerty R F, McIver F A
South Med J. 1978 May;71(5):525-9. doi: 10.1097/00007611-197805000-00014.
National survival statistics for breast cancer victims are basically the same today as they have been for the last 50 years. Less than 60% survive five years after diagnosis, and they frequently must accept mutilating results of treatment. To improve this bleak picture, our efforts should be directed toward prevention. One aspect of prevention would be to identify the breasts most likely to develop malignancies and remove the breast tissue with planned restoration of contour. Subcutaneous mastectomy and immediate insertion of Silastic gel prostheses has not met with the desired results either medically or esthetically. The complications with this procedure are numerous, and there is an unnatural "cystic" appearance on the chest wall with a thin skin covering through which the prostheses can be palpated. We advocate subcutaneous mastectomy with appropriate fixation of the nipples and areolae on the pectoral muscle and fascia, followed several months later by subpectoral augmentation. This two-staged procedure has proved to be a reliable one with few serious complications. It is hoped it will play a significant role not only in reducing the mortality associated with breast cancer but also in lessening the undesirable psychologic impact of the loss of breasts.
如今，乳腺癌患者的全国生存统计数据与过去50年基本相同。不到60%的患者在确诊后能存活五年，而且他们常常不得不接受致残性的治疗结果。为了改善这一黯淡的状况，我们的努力应指向预防。预防的一个方面是识别最有可能发生恶性肿瘤的乳房，并切除乳房组织，同时有计划地恢复外形。皮下乳房切除术并立即植入硅凝胶假体，在医学和美学方面都未取得理想效果。该手术的并发症众多，胸壁上会出现不自然的“囊性”外观，皮肤覆盖较薄，可触摸到假体。我们主张在胸肌和筋膜上对乳头和乳晕进行适当固定后行皮下乳房切除术，数月后再行胸肌下隆乳术。这种两阶段手术已被证明是可靠的，严重并发症很少。希望它不仅能在降低乳腺癌相关死亡率方面发挥重要作用，还能减轻乳房缺失带来的不良心理影响。
