Nos C, Fitoussi A, Bourgeois D, Fourquet A, Salmon R J, Clough K B
Department of Surgery, Institut Curie, Paris, France.
Eur J Surg Oncol. 1998 Dec;24(6):508-14. doi: 10.1016/s0748-7983(98)93356-x.
This series analyses the results of conservative surgery for large lower pole breast cancers by lumpectomy associated with a bilateral remodelling mammoplasty, in order to avoid residual deformities.
This retrospective study concerns 50 patients with a lower pole breast cancer treated between 1986 and 1996 by lumpectomy, mammoplasty and irradiation. The contralateral breast was immediately made symmetrical in all cases. The mean tumour size was 32.5 mm.
The mean weight of the lumpectomy specimen was 270 g. Resection margins were tumour-free in 90% of cases. The main complication observed was delayed healing, thus postponing post-operative treatment in 6.5% of cases. The median follow-up was 48 months. The 5-year actuarial ipsilateral local recurrence rate was 7% and 5-year actuarial metastasis-free and overall survival rates were 81 and 97%, respectively. Cosmesis was satisfactory in 85% of patients. We observed better results when radiotherapy was performed after rather than prior to surgery (92 vs. 67%: NS).
Performing a bilateral mammoplasty at the time of initial surgery for large breast cancers situated in the lower quadrants of the breast facilitates larger lumpectomies with good cosmetic results.
本系列研究分析了通过肿块切除术联合双侧乳房重塑整形术对较大的乳房下极癌进行保乳手术的结果，以避免残留畸形。
这项回顾性研究涉及1986年至1996年间接受肿块切除术、乳房整形术和放疗的50例乳房下极癌患者。所有病例中，对侧乳房均立即进行了对称处理。肿瘤平均大小为32.5毫米。
肿块切除标本的平均重量为270克。90%的病例切缘无肿瘤。观察到的主要并发症是愈合延迟，6.5%的病例因此推迟了术后治疗。中位随访时间为48个月。5年精算同侧局部复发率为7%，5年精算无转移生存率和总生存率分别为81%和97%。85%的患者美容效果满意。我们观察到，放疗在手术后而非手术前进行时效果更好（92%对67%：无显著性差异）。
对于位于乳房下象限的较大乳腺癌，在初次手术时进行双侧乳房整形术有助于进行更大范围的肿块切除术，并获得良好的美容效果。
