• 首都醫(yī)科大學(xué)宣武醫(yī)院普外科(北京 100053);

目的總結(jié)采用乳房整形技術(shù)對早期乳腺癌患者進行保乳手術(shù)治療的臨床經(jīng)驗和術(shù)后美容效果。方法2007年1月至2011年3月期間我院收治的手術(shù)方式為保乳手術(shù)的乳腺癌患者136例，其中59例在保乳手術(shù)時采用了乳房整形技術(shù)，回顧性分析該59例患者的臨床資料，并采用體檢測量和滿意度調(diào)查表的方式對手術(shù)后乳房的美容效果進行評價。結(jié)果患者均為女性，年齡(53.5±9.8)歲，32～77歲。腫瘤直徑為(1.6±0.7) cm，0.5～4.0 cm。腫瘤位于上象限38例，下象限17例，中央?yún)^(qū)4例。手術(shù)切口采用單切口25例，雙切口34例。切除腫瘤后乳腺缺損修復(fù)方法有: 殘留腺體直接縫合法9例，乳腺組織腺蒂瓣轉(zhuǎn)位法35例，局部皮瓣或脂肪筋膜瓣轉(zhuǎn)移法9例，“J”形或雙環(huán)縮乳法4例，背闊肌肌瓣法2例。隨訪3～53個月，平均30個月，未發(fā)現(xiàn)局部和區(qū)域淋巴結(jié)腫瘤復(fù)發(fā); 術(shù)后14個月發(fā)生骨轉(zhuǎn)移1例; 無傷口、皮膚壞死和感染。未發(fā)現(xiàn)死亡病例。乳房美容總評分大于26分者53例，優(yōu)良率為89.8%(53/59)。手術(shù)后乳房美容滿意度調(diào)查顯示，非常滿意40例(67.8%)，滿意14例(23.7%)，一般3例(5.1%)，不滿意2例(3.4%)，無非常不滿意患者。結(jié)論選擇合適的早期乳腺癌患者采用乳房整形技術(shù)進行保乳手術(shù)治療，安全、有效，術(shù)后患者對乳房外形及整體美容效果滿意度高，是值得推薦的一種技術(shù)。

引用本文： 康驊,朱江,海濤,王亞軍. 乳房整形技術(shù)在乳腺癌保乳手術(shù)中的應(yīng)用體會. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(9): 917-921. doi: 復(fù)制

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2. Slavin SA, Halperin T. Reconstruction of the breast conservation deformity [J]. Semin Plast Surg, 2004, 18(2): 8996.
3. Wang HT, Barone CM, Steigelman MB, et al. Aesthetic outcomes in breast conservation therapy [J]. Aesthet Surg J, 2008, 28(2): 165170.
4. Veiga DF, Veigafilho J, Ribeiro LM, et al. Qualityoflife and selfesteem outcomes after oncoplastic breastconserving surgery [J]. Plast Reconstr Surg, 2010, 125(3): 811817.
5. Fitoussi AD, Berry MG, Famà F, et al. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases [J]. Plast Reconstr Surg, 2010, 125(2): 454462.
6. Masetti R, Di LA, Franceschini G, et al. Oncoplastic techniques in the conservative surgical treatment of breast cancer:an overview [J]. Breast J, 2006, 12(5 Suppl 2): S174S180.
7. Fisher B, Anderson S, Bryant J, et al. Twentyyear followup of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer [J]. N Engl J Med, 2002, 347(16): 12331241.
8. Jatoi I, Proschan MA. Randomized trials of breastconserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results [J]. Am J Clin Oncol, 2005, 28(3): 289294.
9. Margenthaler JA. Optimizing conservative breast surgery [J]. J Surg Oncol, 2011, 103(4): 306312.
10. Chan SW, Cheung PS, Chueng PS, et al. Cosmetic outcome and percentage of breast volume excision in oncoplastic breast conserving surgery [J]. World J Surg, 2010, 34(7): 14471452.
11. Taylor ME, Perez CA, Halverson KJ, et al. Factors influencing cosmetic results after conservation therapy for breast cancer [J]. Int J Radiat Oncol Biol Phys, 1995, 31(4): 753764.
12. Lebovic GS. Oncoplastic surgery:a creative approach to breast cancer management [J]. Surg Oncol Clin N Am, 2010, 19(3): 567580.
13. Gainer SM, Lucci A. Oncoplastics: techniques for reconstruction of partial breast defects based on tumor location [J]. J Surg Oncol, 2011, 103(4): 341347.
14. Berry MG, Fitoussi AD, Curnier A, et al. Oncoplastic breast surgery: a review and systematic approach [J]. J Plast Reconstr Aesthet Surg, 2010, 63(8): 12331243.
15. Tan M, Ung O. Alternative approaches for oncoplastic breast surgery [J]. Ann Surg Oncol, 2011, 18(1): 297299.
16. Bulstrode NW, Shrotria S. Prediction of cosmetic outcome following conservative breast surgery using breast volume measurements [J]. Breast, 2001, 10(2): 124126.
17. Law TT, Kwong A. Surgical margins in breast conservation therapy: how much should we excise? [J]. South Med J, 2009, 102(12): 12341237.
18. Malka I, Villet R, Fitoussi A, et al. Oncoplastic conservative treatment for breast cancer. Part 2. Techniques for the inferior quadrants [J]. J Visc Surg, 2010, 147(5): e305e315.
19. Kijima Y, Yoshinaka H, Owaki T, et al. Immediate reconstruction using inframammary adipofascial flap of the anterior rectus sheath after partial mastectomy [J]. Am J Surg, 2007, 193(6): 789791.
20. Zaha H, Sunagawa H, Kawakami K, et al. Partial breast reconstruction for an inferomedial breast carcinoma using an omental flap [J]. World J Surg, 2010, 34(8): 17821787.
  1. 1. Bajaj AK, Kon PS, Oberg KC, et al. Aesthetic outcomes in patients undergoing breast conservation therapy for the treatment of localized breast cancer [J]. Plast Reconstr Surg, 2004, 114(6): 14421449.
  2. 2. Slavin SA, Halperin T. Reconstruction of the breast conservation deformity [J]. Semin Plast Surg, 2004, 18(2): 8996.
  3. 3. Wang HT, Barone CM, Steigelman MB, et al. Aesthetic outcomes in breast conservation therapy [J]. Aesthet Surg J, 2008, 28(2): 165170.
  4. 4. Veiga DF, Veigafilho J, Ribeiro LM, et al. Qualityoflife and selfesteem outcomes after oncoplastic breastconserving surgery [J]. Plast Reconstr Surg, 2010, 125(3): 811817.
  5. 5. Fitoussi AD, Berry MG, Famà F, et al. Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases [J]. Plast Reconstr Surg, 2010, 125(2): 454462.
  6. 6. Masetti R, Di LA, Franceschini G, et al. Oncoplastic techniques in the conservative surgical treatment of breast cancer:an overview [J]. Breast J, 2006, 12(5 Suppl 2): S174S180.
  7. 7. Fisher B, Anderson S, Bryant J, et al. Twentyyear followup of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer [J]. N Engl J Med, 2002, 347(16): 12331241.
  8. 8. Jatoi I, Proschan MA. Randomized trials of breastconserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results [J]. Am J Clin Oncol, 2005, 28(3): 289294.
  9. 9. Margenthaler JA. Optimizing conservative breast surgery [J]. J Surg Oncol, 2011, 103(4): 306312.
  10. 10. Chan SW, Cheung PS, Chueng PS, et al. Cosmetic outcome and percentage of breast volume excision in oncoplastic breast conserving surgery [J]. World J Surg, 2010, 34(7): 14471452.
  11. 11. Taylor ME, Perez CA, Halverson KJ, et al. Factors influencing cosmetic results after conservation therapy for breast cancer [J]. Int J Radiat Oncol Biol Phys, 1995, 31(4): 753764.
  12. 12. Lebovic GS. Oncoplastic surgery:a creative approach to breast cancer management [J]. Surg Oncol Clin N Am, 2010, 19(3): 567580.
  13. 13. Gainer SM, Lucci A. Oncoplastics: techniques for reconstruction of partial breast defects based on tumor location [J]. J Surg Oncol, 2011, 103(4): 341347.
  14. 14. Berry MG, Fitoussi AD, Curnier A, et al. Oncoplastic breast surgery: a review and systematic approach [J]. J Plast Reconstr Aesthet Surg, 2010, 63(8): 12331243.
  15. 15. Tan M, Ung O. Alternative approaches for oncoplastic breast surgery [J]. Ann Surg Oncol, 2011, 18(1): 297299.
  16. 16. Bulstrode NW, Shrotria S. Prediction of cosmetic outcome following conservative breast surgery using breast volume measurements [J]. Breast, 2001, 10(2): 124126.
  17. 17. Law TT, Kwong A. Surgical margins in breast conservation therapy: how much should we excise? [J]. South Med J, 2009, 102(12): 12341237.
  18. 18. Malka I, Villet R, Fitoussi A, et al. Oncoplastic conservative treatment for breast cancer. Part 2. Techniques for the inferior quadrants [J]. J Visc Surg, 2010, 147(5): e305e315.
  19. 19. Kijima Y, Yoshinaka H, Owaki T, et al. Immediate reconstruction using inframammary adipofascial flap of the anterior rectus sheath after partial mastectomy [J]. Am J Surg, 2007, 193(6): 789791.
  20. 20. Zaha H, Sunagawa H, Kawakami K, et al. Partial breast reconstruction for an inferomedial breast carcinoma using an omental flap [J]. World J Surg, 2010, 34(8): 17821787.