Krishnan L, Krishnan E C, Wolf C D, Jewell W R
Department of Radiation Oncology, University of Kansas Medical Center, Kansas City 66160.
Radiographics. 1993 Jul;13(4):831-9. doi: 10.1148/radiographics.13.4.8356271.
It is not uncommon for a patient who has previously undergone breast augmentation to be diagnosed with breast cancer. The options available to such a patient are a modified radical mastectomy and breast conservation treatment. If the patient chooses breast conservation treatment, the concerns that need to be addressed are whether the breast prosthesis should be removed before irradiation and whether the presence of the prosthesis would impair local control of the tumor or cosmetic results. This article presents the feasibility of breast conservation treatment without impairing the augmentation. Five patients underwent lumpectomy, perioperative placement of interstitial catheters in the tumor bed for immediate postoperative boost brachytherapy, and external beam irradiation to the entire breast. Results of follow-up examinations for a median of 60 months revealed successful local control and satisfactory cosmetic results. No long-term effects of radiation therapy on the breast prostheses have been observed. Thus, it seems feasible to conserve the breast and the augmentation with limited surgical resection and radiation therapy, including an immediate interstitial boost.
对于曾接受过隆胸手术的患者而言，被诊断出患有乳腺癌的情况并不罕见。这类患者可选择的治疗方案有改良根治性乳房切除术和保乳治疗。如果患者选择保乳治疗，那么需要解决的问题是在放疗前是否应取出乳房假体，以及假体的存在是否会影响肿瘤的局部控制或美容效果。本文介绍了在不影响隆胸效果的前提下进行保乳治疗的可行性。5例患者接受了肿块切除术，术中在肿瘤床放置组织间导管以便术后即刻进行近距离放疗推量，然后对整个乳房进行外照射。中位随访60个月的检查结果显示，局部控制成功且美容效果令人满意。未观察到放疗对乳房假体产生长期影响。因此，通过有限的手术切除和放疗（包括即刻组织间推量）来保留乳房及隆胸效果似乎是可行的。
