乳房整形技术在乳腺癌保乳手术中的应用效果分析

目的：探究分析在乳腺癌保乳手术当中,乳房整形手术的应用临床效果。方法：选自我院2010年～2012年收治的在保乳手术当中应用乳房整形手术的患者共50例,对其,I盘床资料进行回顾性分析,对患者术后美容效果进行调查。结果：全部患者均成功完成手术,术后对患者进行随访,随访时间为（6～12）个月,无患者出现局部或者区域淋巴结肿瘤复发迹象;患者手术后乳房美容效果优良率为92％（46／5O）。结论：乳腺癌患者可以通过乳房整形技术进行保乳治疗,该手术方法有着安全高效的优点,手术之后患者乳房外形以及整体美容整体满意程度较高,值得临床推广。     

乳房整形技术在乳腺癌保乳手术中的应用体会

目的 总结采用乳房整形技术对早期乳腺癌患者进行保乳手术治疗的临床经验和术后美容效果.方法 2007年1月至2011年3月期间我院收治的手术方式为保乳手术的乳腺癌患者136例,其中59例在保乳手术时采用了乳房整形技术,回顾性分析该59例患者的临床资料,并采用体检测量和满意度调查表的方式对手术后乳房的美容效果进行评价.结果...     

乳腺癌保乳手术的体会

目的　总结和探讨乳腺癌保乳手术保持乳房良好外形 ,在术前、术中和术后应注意的问题。方法　 3 7例患者接受了乳腺癌保乳手术。术后从乳头外观、双乳头水平差距、双乳头距同侧腋前线垂直距离之差距和瘢痕对乳房外形影响等四个方面的量化标准 ,评估保留乳房的外形美观效果。四项指标积分≥ 2 1分为优 ,13～ 2 0分为良 ,<13分为差。结果　术后保留乳房外形优良者 3 0例 ( 81.1% ) ,乳房外形较差者 7例 ( 18.9% )。常见问题是因切口瘢痕致乳房变形、乳头歪斜、乳头不自然挺立 ,以及与对侧乳头水平高度差距明显。结论　术前认真设计手术切口、术中注意术区皮瓣和保留乳腺组织的彻底游离以及切除、缝合技巧 ,术后切口包扎时注意避免压迫乳头等 ,将有助于保持保留乳房的外形美观效果     

乳腺癌保乳手术与重建策略

随着乳腺外科的发展,乳腺癌手术治疗术式有了更多选择.对于早期乳腺癌病人,保乳手术仍应是首选手术方式之一,肿瘤整形保乳可以扩大该手术的适应证.对于缺乏保乳指征的病人,应合理选择乳房重建手术的方法和时机.乳房重建手术可分为即刻重建、延期重建和即刻-延期重建3种术式.具体方法包括植入物重建、自体皮瓣重建和脂肪移植等.对称性手...     

乳腺癌保乳术乳房整形的护理和术后评价

【摘要】〓目的〓探讨乳腺癌保乳术中乳房整形技术的应用和护理。方法〓将我院已确诊为乳腺癌,最大径<5.0 cm且有保乳意愿的患者40例应用乳房整形技术行保乳术并进行相应的护理。另选取30例同期行传统保乳术和常规护理的患者作为对照。统计分析两组术后不良反应和并发症、客观和患者主观满意度调查所得的美容效果以及生活质量。结果〓观察组美容效果主观评分为优、良的患者比例分别为15%和35%,均显著高于对照组的6.67%和23.33%,而观察组美容效果主观评分为差和很差的患者比例分别为7.5%和2.5%,均显著低于对照组的20%和13.33%;观察组美容效果客观评分为3分和4分的患者比例分别为32.5%和30%,均显著高于对照组的16.67%和13.33%,而观察组美容效果客观评分为1分和2分的患者比例分别为2.5%和35%,均显著低于对照组的16.67%和53.33%,差异有统计学意义(P<0.01)。护理前两组生活质量比较差异无统计学意义(P>0.05),护理后观察组躯体功能、总体健康、活力等8个维度的生活质量评分均较对照组提高,差异有统计学意义(P<0.05)。观察组切口感染、乳头、乳晕及乳瓣坏死、患侧上肢淋巴水肿等不良反应和并发症发生率为12.5%,对照组不良反应和并发症发生率为20%,两组差异不良反应和并发症发生情况比较差异无统计学意义(P>0.05)。结论〓乳腺癌患者保乳术中采用乳房整形技术并进行相应的护理可有效提高美容效果,改善患者的生活质量且不会增加不良反应和并发症,值得临床推广使用。     

乳腺癌保乳术后背阔肌肌瓣转移修复乳房缺损28例

目的：探讨早期乳腺癌保乳术后乳房缺损的修复方法。方法：对28例早期乳腺癌保乳术患者应用带蒂背阔肌瓣一期修复乳腺缺损,术后给予辅助放化疗等综合治疗,评价其乳房外形及触感。结果：经过1.5～5年的随访,28例背阔肌肌瓣一期修复乳腺缺损区后全部成活,乳房外形和触感满意率均为89.3%。结论：保乳术后即刻背阔肌肌瓣修复乳房缺损的应用,扩大了保乳手术的适应证,同时得到良好的乳房美容效果。     

乳腺癌保乳手术方式的选择

早期乳腺癌保乳术在国内已经被越来越多的人所认可,国内外已有大量的文献报道[1].保乳的治疗效果与改良根治术相当,术后并发症少,手术创伤轻,术后乳房外观美容效果满意.但应密切注意手术方式的选择和设计,现就相关问题讨论如下.     

整形性体积易位技术对乳腺癌保乳术后乳房美学效果的影响

目的:探讨整形性体积易位技术对乳腺癌保乳术后乳房美容效果的影响.方法:选取2016年8月-2018年2月在笔者医院行保乳手术治疗的乳腺癌患者102例,依据随机数字表法将患者分为实验组和对照组,各51例.两组患者均行保乳手术治疗,实验组给予整形性体积易位技术缝合,对照组在肿瘤切除后仅行部分腺体缝合或直接缝合残留腺体.比较...     

预见性护理对乳腺癌整形保乳术患者乳房美观度的影响

目的 观察预见性护理应用于乳腺癌整形保乳术后对患者乳房美观度的影响。方法 选择2022年 5月-2023年2月于我院行乳腺癌整形保乳术的44例患者为研究对象,采用随机数字表法分为对照组和研究 组,每组22例。对照组给予常规护理,研究组给予预见性护理,比较两组乳房美观度、乳房美容效果及心 理状况。结果 研究组乳头纵向移位距离、乳头横向移位距离、乳房凹陷程度、瘢痕增生、乳房对称性评 分均高于对照组（P＜0.05）;研究组乳房美容优良率为90.91%,高于对照组的59.09%（P＜0.05）;研究组 护理后HAMD评分、HAMA评分均低于对照组（P＜0.05）。结论 为乳腺癌整形保乳术后患者提供预见性 护理能有效改善乳房美容度,提升乳房美容效果,有利于调节患者的不良情绪,值得临床应用。     

乳腺癌保乳术后乳房畸形修复手术的选择

目的 探讨保乳术后继发乳房畸形的原因及预防方法,以及根据乳房畸形的不同程度采用不同方法进行修复重建的治疗效果.方法 选择行乳腺癌保乳术后1年以上,化疗及放疗结束半年以上,无局部复发及远位转移,患侧乳房出现继发畸形,要求修复重建患者30例,对患侧乳房进行瘢痕切除、挛缩松解,并根据组织缺损的不同程度,选择不同的方法进行修复重建,7例应用局部乳腺瓣法,21例应用背阔肌肌皮瓣法,2例采用横行腹直肌肌皮瓣法.结果 术后乳房形态及手感良好,优23例(76.7％),良7例(23.3％).术后所有患者平均随访约2.5年,目前均处于无瘤生存状态.结论 保乳术后继发乳房畸形,可根据畸形不同程度,选择不同方法进行修复重建,修复重建后乳房形态良好.     

Application of Ultimate Oncoplastic Surgery in Breast-Conserving Surgery

ObjectiveTo investigate the application of oncoplastic surgery in breast-conserving surgery.MethodsWe retrospectively analyzed the clinical data of 103 breast cancer patients who underwent breast-conserving surgery in the First Affiliated Hospital of Henan University. All the patients were female whose tumor volume-to-breast volume ratio was greater than 20%. Fifty-two patients were treated with oncoplastic breast-conversing surgery (observation group), and 51 patients were treated with traditional breast-conserving surgery (control group). The volume of resected tissue, subjective satisfaction with breast shape, objective score of breast shape, and follow-up were compared between the two groups.ResultsIn the observation group, the weight of resected breast tissue was 64.2–172.1 g, with a median of 98.7 g. In the control group, the weight of resected breast tissue was 67.5–175.7 g, with a median of 102.3 g. After 12 months of follow-up, the subjective satisfaction rate and objective score of breast shape in the observation group were significantly better than those in the traditional breast-conserving surgery group (P < 0.05). There was no recurrence, metastasis, or death in the two groups. There was no significant difference in postoperative complications between the two groups (P > 0.05).ConclusionOncoplastic breast-conserving surgery leads to better cosmetic results and a more satisfactory clinical results.     

乳腺密度与乳腺癌保乳手术后复发风险的关系

目的探讨乳腺X密度等级与乳腺癌保乳术后复发风险的关系。方法 2002年1月～2005年7月,180例接受保乳手术的乳腺癌在术后5～8年(平均6.1年)进行随访,对术前X线乳腺钼靶像按照BI-RADS标准,以乳腺百分密度分为25%、25%～50%、51%～75%、75%4个等级,以包含乳腺密度在内的11个相关因素做单因素分析筛选出有意义的影响因素再进行logistic回归多因素分析,评价乳腺密度与乳癌保乳术后复发的关系。结果 logistic回归多因素分析显示术后放疗和乳腺密度是术后复发的影响因素(Waldχ2=9.429,P=0.002;Waldχ2=9.346,P=0.002);4个密度组的复发率依次为6.2%(3/48)、12.0%(6/50)、11.6%(5/43)、28.2%(11/39),乳腺密度越高,局部复发风险越大。乳腺密度不是术后转移的影响因素(Waldχ2=2.944,P=0.400),各密度组间远处转移率依次为16.7%(8/48)、14.0%(7/50)、7.0%(3/43)、7.7%(3/39),远处转移风险不随乳腺密度增高而加大。术后化疗和腋窝淋巴结转移是术后转移的影响因素(Waldχ2=4.334,P=0.037;Waldχ2=4.417,P=0.036)。结论乳腺密度与乳腺癌保乳术后复发有相关性,但不是术后远处转移的危险因素。     

Breast-Conserving Surgery Versus Mastectomy for Survival from Breast Cancer: the Western Australian Experience

Background The focus of this study was the relative survival rates of breast cancer patients whose treatment was breast-conserving surgery compared with that of mastectomy, adjusting for tumor size and nodal status because these factors may be intrinsically associated with mastectomy being the treatment of choice. Patient age was also accounted for in the model. By adjusting for these factors, we mitigate them as confounders of treatment choice in assessing effects on survival rates. Methods Data were sourced from linked administrative data from the Western Australian Department of Health Record Linkage Unit. The data consisted of linked records containing the diagnosis, subsequent hospital admission, and death records of about 3000 women diagnosed with cancer in Western Australia between 1 January 1995 and 31 December 1999. Cox proportional hazards regression was used to investigate survival outcomes of breast-conserving surgery compared with that of mastectomy, adjusting for tumor size, nodal status, and subject age. Results The hazard of death is reduced by a factor of about one half for subjects whose treatment was breast-conserving surgery over treatment by mastectomy. Furthermore, the hazard of death increases substantially for subjects with nodal involvement over subjects for whom there has been no identified spread to regional lymph nodes. Hazard of death increases as both age and tumor size increase. Conclusions Western Australian breast cancer patients treated with breast-conserving surgery have improved survival outcomes over those treated with mastectomy, after allowing for tumor size, patient age, and lymph node involvement.     

整形技术在乳腺癌乳房再造治疗中的应用

乳腺癌作为多发的恶性肿瘤疾病之一,临床常采用手术方式进行治疗。近年来,国内的医学诊 断和治疗技术不断得到提高,乳腺癌的手术诊疗手段也有很大的进展。但由于部分患者切除了病变乳房, 生理及精神均受到不同程度的创伤。因此,整形外科诊疗技术在乳腺癌治疗中被广泛使用,在解决患者癌 症病灶的同时能够兼顾患者的生理形态美,保证患者生活质量。基于此,本文就乳房再造术、乳房重建手 术类型及其辅助技术作一综述,旨在为乳腺癌患者的相关手术治疗提供参考     

Telomerase Activity Levels for Evaluating the Surgical Margin in Breast-Conserving Surgery

To evaluate the efficiency of measuring telomerase activity levels in clinical diagnosis, we performed a semiquantitative analysis of telomerase activity in breast tumors and compared the results with the histological findings. Breast tissue adjacent to areas of cancer were also serially resected and checked for telomerase activity. The amount of telomerase activity in the breast cancers ranged widely, from 0.36 to 1 180 units/μg, with 31 of the 34 (91.2%) showing a value above 1.0 unit/μg. None of the normal breast tissues including mastopathy, and only 4 (23.5%) of 17 benign breast masses had values above 1.0 unit/μg. Telomerase activity was detectable in serial sections of adjacent tissues as far as 10 mm from the macroscopic tumor margin with histologically detectable cancer cells. Furthermore, telomerase activity was detectable in the scrape specimens obtained from the stump of the surgical margins for breast-conserving surgery, and this activity was in accordance with the histological findings. These findings show that conducting a semiquantitative assay of telomerase activity is useful for evaluating the surgical margin in breast-conserving surgery. Received: May 10, 2000 / Accepted: September 26, 2000     

局部皮瓣在乳腺癌保乳术后一期修复中的应用

目的 观察应用局部皮瓣修复保乳术后乳房缺损的临床疗效。方法 2004年7月至2013年1月,对9例早期乳腺癌患者保乳手术所遗留的乳房缺损进行即刻修复,采用外侧胸背筋膜皮瓣7例,胸腹壁皮瓣2例,观察皮瓣成活情况、并发症和术后美观效果。结果 术后外观评价8例为优,1例为良。1例患者出现皮瓣局部坏死,经保守治疗愈合。1例患者出现皮瓣供区感染,口服抗菌素治疗,未影响手术效果。术后平均随访22个月,未见局部复发病例。结论 应用局部皮瓣修复保乳术后乳房部分缺损,手术效果好,并发症少,可扩大肿瘤周围的切除范围,降低肿瘤局部复发风险。     

Predictors of Re-excision among Women Undergoing Breast-Conserving Surgery for Cancer

Background Up to 60% of breast cancer patients who undergo breast-conserving surgery (BCS) require re-excision to obtain clear margins, causing delays in adjuvant treatment and poor aesthetic results. However, patient and treatment-related factors associated with re-excision are not well defined. Methods We surveyed all women undergoing breast conserving surgery between January 2002 and May 2006 regarding their breast disease (n = 714, response rate = 79.5%). The medical record was reviewed to determine the receipt of re-excision lumpectomy following BCS, and obtain tumor stage, histology, and biopsy method (surgical versus needle biopsy). Patient age, breast size, tumor location in the breast, and receipt of chemotherapy were self-reported. Logistic regression was used to determine significant predictors of re-excision lumpectomy. Results In this sample, 51.4% of women required only one breast excision, 41.9% required two breast excisions, and 6.6% required three breast excisions. Overall, 10.8% of women required a mastectomy following initial attempt at BCS. Factors significantly correlated with re-excision lumpectomy included smaller breast size (A cup: OR = 2.7; 95%CI: 1.32–5.52; B cup: 1.63; 95%CI: 1.02–2.62), lobular histology (OR = 1.93; 95%CI: 1.15–3.25), and receipt of surgical biopsy (OR = 3.35; 95%CI: 2.24–5.02). Women who received adjuvant chemotherapy (OR = 2.49; 95%CI: 1.19–5.22) were more likely to require re-excision compared with women who received neoadjuvant chemotherapy. Conclusions Re-excision lumpectomy is common, and is significantly correlated with smaller breast size, lobular histology, surgical biopsy, and chemotherapy timing. Attention to these risk factors can improve the quality of care delivered to BCS patients by decreasing the cost and morbidity associated with multiple re-excision procedures.     

Comparative Study of Surgical Margins in Oncoplastic Surgery and Quadrantectomy in Breast Cancer

Background Oncoplastic surgery for breast cancer is a novel concept that combines a plastic surgical procedure with breast-conserving treatment to improve the final cosmetic results. The aim of this study was to evaluate the oncological safety of oncoplastic procedures by studying the status of the surgical margins of the excised tumor specimen in comparison with standard quadrantectomies.Methods Thirty consecutive breast cancer patients undergoing oncoplastic surgery (group 1) and 30 patients undergoing standard quadrantectomy (group 2) were prospectively studied with regard to the stage of breast cancer, the surgical procedures performed, the volume of breast tissue excised, and the histopathology of the tumor specimen, with specific details on surgical margins.Results Patients who underwent oncoplastic surgery (group 1) were younger (mean age, 48.73 years) than patients who had a classic quadrantectomy (group 2; mean age, 55.76 years; P = .022). The mean volume of the excised specimen in group 1 was 200.18 cm³, compared with 117.55 cm³ in group 2 (P = .016). Surgical margins were negative in 25 cases out of 30 in group 1 and 17 out of 30 in group 2 (P = .05). The average length of the surgical margin was 8.5 mm in group 1 and 6.5 mm in group 2, but the difference was not statistically significant (P = .074).Conclusions Oncoplastic surgery adds to the oncological safety of breast-conserving treatment because a larger volume of breast tissue can be excised and a wider negative margin can be obtained. It is especially indicated for large tumors, for which standard breast-conserving treatment has a high probability of leaving positive margins.