Dieterich H, Schwab R, Landmann C, Torhorst J
Frauenklinik Rheinfelden, Universität Basel.
Zentralbl Gynakol. 1996;118(6):374-8.
The present paper is based on the prospective data on breast conserving therapy recorded since 1977 in the "Basel protocol". Here both surgical and radio-oncological procedures are standardized, and a form sheet is provided for registering the pathological findings. Since our data showed that local recurrence free survival of patients treated by tumor resection only just in sano or questionably in sano was statistically significantly worse, it was decided to fill the volume defect occurring during breast conserving therapy with autologous tissue, in selected cases. Also an adjuvant radiation therapy was performed. Since January. 1st, 1992 we performed volume substitution by a latissimus dorsi flap in 27 patients treated by a surgically "enlarged" breast conserving concept. A classical skin muscle island, a deepithelized skin muscle island or a mere muscle island flap were performed. Aim of this pilot study was to further optimize early and late cosmetic results, to enlarge indication for breast conserving therapy and improve loco-regional tumor control.
本文基于自1977年起在“巴塞尔方案”中记录的保乳治疗前瞻性数据。在此，手术和放射肿瘤学程序均已标准化，并提供了一张表格用于记录病理结果。由于我们的数据显示，仅接受肿瘤切除且切除范围仅为大体正常或可疑大体正常的患者的无局部复发生存率在统计学上显著更差，因此决定在选定病例中用自体组织填充保乳治疗期间出现的容积缺损。此外，还进行了辅助放疗。自1992年1月1日起，我们对27例接受手术“扩大”保乳概念治疗的患者采用背阔肌肌皮瓣进行了容积替代。采用了经典的带蒂皮肌瓣、去上皮化带蒂皮肌瓣或单纯肌瓣。这项初步研究的目的是进一步优化早期和晚期美容效果，扩大保乳治疗的适应症并改善局部区域肿瘤控制。
