• 首都醫(yī)科大學宣武醫(yī)院普外科(北京 100053);

目的總結采用乳房整形技術對早期乳腺癌患者進行保乳手術治療的臨床經(jīng)驗和術后美容效果。方法2007年1月至2011年3月期間我院收治的手術方式為保乳手術的乳腺癌患者136例，其中59例在保乳手術時采用了乳房整形技術，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查表的方式對手術后乳房的美容效果進行評價。結果患者均為女性，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方法有: 殘留腺體直接縫合法9例，乳腺組織腺蒂瓣轉位法35例，局部皮瓣或脂肪筋膜瓣轉移法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)域淋巴結腫瘤復發(fā); 術后14個月發(fā)生骨轉移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)。手術后乳房美容滿意度調查顯示，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。結論選擇合適的早期乳腺癌患者采用乳房整形技術進行保乳手術治療，安全、有效，術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。

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

版權信息： ?四川大學華西醫(yī)院華西期刊社《中國普外基礎與臨床雜志》版權所有，未經(jīng)授權不得轉載、改編

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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.