保留乳头乳晕复合体乳房切除术中即刻乳房重建12例分析

目的:总结保留乳头乳晕复合体乳腺癌根治术后背阔肌皮瓣加假体置入即刻乳房重建的疗效?方法:对2011年10月—2014年8月在泰州市人民医院采取保留乳头乳晕复合体乳腺癌根治术后背阔肌皮瓣加假体置入即刻乳房重建的12例乳腺癌患者进行随访,观察乳头乳晕血运?皮瓣存活率?引流量和并发症发生率,并对其美容效果进行评估?结果:12例患者均手术成功,术后乳头乳晕血运良好,皮瓣顺利成活,均无严重手术并发症,重建乳房形态完美,增加了美感,减轻了患者的精神负担?结论:保留乳头乳晕复合体乳腺癌根治术后背阔肌皮瓣加假体置入即刻乳房重建的临床效果良好,不但有改良根治术相同的安全性,而且有更好的美观性,值得临床推广应用?     

乳腺癌术后Ⅰ期假体植入乳房重建术42例临床分析

目的：探讨乳腺癌术后Ⅰ期假体植入乳房重建的临床应用价值。方法对42例患者在行乳腺癌手术的同时,于胸大肌后方Ⅰ期硅胶假体植入行乳房重建术,对围手术期结果、乳房外观评价以及随访结果进行分析。结果32例保留乳头乳晕复合体,10例切除;3例单侧乳腺癌行背阔肌肌皮瓣转移术＋假体植入术,3例同时行乳房重建术和双乳对称性手术（含1例双乳癌）。术后外观评价均为良,患者满意。所有患者乳头乳晕复合体及皮瓣均无缺血坏死,术后1例伤口感染,1例放疗后包囊挛缩。所有患者术后均获随访,随访时间为10～101个月（中位随访时间22个月）,40例未出现局部复发、远处转移,2例死亡。所有患者乳房外观及手感满意。结论乳腺癌术后Ⅰ期假体植入乳房重建术,具有诸多优点,但也要看到其缺点,临床医生不要盲目行乳房重建;切缘安全是保留皮肤、乳头和乳晕手术的前提;结合患者意愿、肿瘤临床分期、生物学行为、分子分型作充分评估,要考虑到对侧乳房的对称性问题,来选择适合患者的重建手术。     

保留乳头乳晕复合体的乳腺癌改良根治术的进展

保留乳头乳晕复合体乳腺癌改良根治术(NSM)又称皮下乳腺切除加腋窝淋巴结清扫术,是在传统的保留胸肌的乳腺癌改良根治术的基础上保留乳头乳晕复合体的手术。在手术后保留了术后重建乳房的美学效果和提高了生活质量。随着外科技术的进步以及各种辅助治疗的发展,现在越来越多的患者选择该种手术。本文主要讨论影响乳腺癌患者NAC浸润相关因素。通过了解NAC浸润的危险因素,来明确NSM适应症以及评估NSM后患者NAC的复发。     

乳腺癌保留乳头乳晕复合体根治术后即刻背阔肌组织瓣重建手术要点分析

环乳晕切口乳腺癌保留乳头乳晕复合体根治术后即刻背阔肌组织瓣重建手术质量控制的目标是减少或防止局部复发和远处转移,减少手术并发症,同时注重患者乳房外形的美观,使患者术后的外在形象可以得到优化,有利于缓解患者的心理创伤,进而提升其生存质量。本文重点讨论手术过程中的核心要点,探寻、提高乳腺癌保留乳头乳晕复合体根治术后即刻背阔肌组织瓣重建手术的质量。     

保留皮肤的乳腺癌改良根治术Ⅰ期假体植入重建乳房的探讨

目的探讨保留皮肤的乳腺癌改良根治术Ⅰ期假体植入乳房重建的可行性。方法对15例Ⅰ、Ⅱ期乳腺癌患者行保留皮肤的乳腺癌改良根治术后,同期于胸大、小肌间植入硅胶假体重建乳房。结果保留乳头乳晕复合体5例,不保留乳头乳晕复合体10例,术后随访5～27个月,术后外观良好,双侧乳房对称,优良率达97%。所有病例均无局部复发或远处转移。结论保留皮肤的乳腺癌改良根治术后用硅胶假体行即刻乳房重建,具有操作方便、效果明显,是安全可行的手术方法。     

乳腺癌与Ⅰ期乳房再造术

目的 探讨乳腺癌患者在行乳腺癌改良根治术（或根治术）的同时，实施几种保留乳房外形的美容手术方法。方法 对不同分期的乳腺癌患者行改良根治术（或根治术）及Ⅰ期腹直肌肌皮瓣乳房再造术，或Ⅰ期假体置入重建并植皮术；对能保留乳头乳晕者行保留乳头乳晕复合体的乳腺癌改良根治术；对有生育要求的患者行改良根治术及背阔肌肌皮辩转移乳房再造并假体置入术。结果 行保留乳头乳晕复合体的改良根治术及Ⅰ期腹直肌肌皮辩乳房再造术者8例，行Ⅰ期假体置入重建并植皮术者15例；行不保留乳头乳晕复合体的改良根治术及Ⅰ期腹直肌肌皮瓣乳房再造术者8例，Ⅰ期假体置入重建并植皮术者2例；行保留乳头乳晕复合体的改良根治术及背阔肌肌皮辩转移乳房再造并假体置入术者2例。所有病例术后随访6～46个月，均无肿瘤局部复发及远处转移，1例根治术及腹直肌肌皮瓣转移乳房再造术后46个月对侧发生乳腺癌。重建乳房外形良好，乳房下皱襞弧度好，保留乳头乳晕区皮肤无坏死；皮肤无萎缩变硬，手感良好；腹部供区无腹壁疝形成，置入假体手感好，移植皮辩无坏死。结论 对不同分期的乳腺癌患者在治疗乳腺疾病的同时，采取多种Ⅰ期乳房重建术能最大限度地保留乳房外形的美观，是较好的治疗方法，在临床需大样本研究来推广。     

保留乳头乳晕复合体乳腺癌改良根治术后背阔肌肌皮瓣乳房再造

目的研究保留乳头乳晕复合体乳腺癌改良根治术后背阔肌肌皮瓣乳房再造安全性与美观性。方法 2005年1月-2011年4月30例早期乳腺癌,在保留乳头、乳晕改良根治术的同时进行背阔肌肌皮瓣乳房再造。结果 30例手术均成功,术后1例出现乳头部分坏死,术后1例出现再造乳房僵硬,术后腋窝形态美观,腋窝无1例积液,5d拔出引流管,20例患者术后半年左右乳头恢复感觉。术后患者均随访1-5年,术后无1例出现局部复发,1例4年后出现肺部转移。重建的乳房形态完美,增加了美感,减轻了患者的精神负担。结论保留乳头乳晕复合体乳腺癌改良根治术后背阔肌肌皮瓣乳房再造,不但有改良根治术相同的安全性,而且有更好的美观性,可望作为早期乳腺癌手术治疗的常规选择术式。     

乳腺癌术后Ⅰ期乳房再造中腔镜与开放假体重建的单中心回顾性研究

目的 比较腔镜下乳房切除术后即刻植入物重建与开放手术的并发症与满意度相关分析。方法 纳入2019年1月—2022年5月本院收治早期乳腺癌接受术后乳房即刻重建的患者96例,分为腔镜手术组36例,开放手术组60例。采用行非参数检验、Mann-Whitney U检验、Logistic 回归分析比较两组患者年龄、肿瘤位置、手术方式、组织学分级、新辅助化疗、辅助化疗、放疗、是否保留乳头乳晕、有无并发症、是否局部复发及满意度相关因素。结果 两组患者年龄经非参数检验差异无统计学意义（P＞0.05）。组织学分级、肿瘤位置、新辅助化疗、是否保留乳头乳晕的构成比存在显著差异（P＜0.05）,手术方式、辅助化疗、辅助放疗、术后并发症与局部复发在不同组别之间经 构成比差异无统计学意义（P＞0.05）。在单因素Logistic 回归中行前哨淋巴结活检、腋窝淋巴结清扫术、新辅助化疗治疗、辅助放疗治疗、保留乳头乳晕与即刻乳房重建术后并发症的发生具有相关性（P＜ 0.05）。多因素分析提示,腋窝淋巴结清扫、假体体积、高血压、保留乳头乳晕是并发症发生率的相对独立的影响因素。结论 单孔充气法腔镜辅助乳房皮下切除假体植入Ⅰ期乳房重建对于符合条件的乳腺癌安全可行,具有创口小、并发症发生率低及相关风险可控,获得较好的根治效果和乳房形态,患者生活质量和满意度高,可在临床推广应用     

腔镜辅助两切口保留乳头乳晕乳腺癌术后即刻背阔肌乳房重建的临床研究

目的探讨采用两切口在腔镜辅助下行保留乳头乳晕复合体的改良乳腺癌根治术后即刻应用背阔肌进行乳房重建的可行性与美容效果。方法 2011年9月~2014年9月,对18例患者在腔镜辅助下进行乳腺癌行保留乳头乳晕的乳腺癌改良根治术,术后即刻应用背阔肌肌瓣进行缺损充填乳房重建,术后评价其重建效果。结果1S例患者手术成功,恢复良好,术后7例皮下积液,3例出现血清肿,2例出现部分乳头坏死、均经处理后愈合;形态良好,16例患者评价为优,非常满意,2例评价为良、较为满意。患者均获随访3~60个月、所有患者均生存、均无远处转移及局部复发。结论在腔镜辅助下采用两切口进行保留乳头乳晕复合体的乳腺癌改良根治术后同侧背阔肌肌瓣即刻乳房重建,手术安全,技术可行,术后切口隐蔽,可以获得非常好的的乳房形态与美容效果。     

乳腺癌保留乳头乳晕复合体改良根治术术后并发症的防治

目的:探讨早期乳腺癌行保留乳头乳晕复合体改良根治手术可行性、术后并发症及防治措施。方法:回顾性分析采用保留乳头乳晕复合体改良根治术治疗35例乳腺癌患者的临床资料。结果:35例患者中,术后发生乳头表皮部分坏死2例,1个月后乳头皮肤痂下愈合;皮下积液5例,其中合并感染1例,经穿刺抽液及抗感染治疗治愈;28例切口甲级愈合,顺利出院。结论:保留乳头乳晕复合体改良根治术既达到了根治性切除目的,又可保持乳房的自然形态及功能,受到患者欢迎,术中精细操作及科学的防治措施可以减少术后并发症。     

乳腺癌术后乳房再造围手术期的护理

目的介绍乳腺癌根治术后一期乳房再造的护理体会。方法应用乳房假体对5例Ⅰ-Ⅱb期乳腺癌术后患者行即时乳房再造。结果本组术后随诊4个月-2年,无排斥反应,美容效果好,无局部疼痛及不适。乳头血运良好,无挛缩。结论本手术方法简单,损伤小,不影响术后放疗及化疗.与二期乳房再造相比减少费用。     

乳腺神经内分泌癌的研究进展

乳腺神经内分泌癌（neuroendocrine carcinoma of breast,NEBC）是一种临床上较为罕见的乳腺肿瘤,尚缺乏明确的规范化诊疗指南,该病的组织起源尚不明确,目前主要有三种观点,其中,NEBC可能是乳腺干细胞分化为神经内分泌和上皮细胞的早期结果这一观点更被接受。NEBC临床特征及病理特征稍突出,但影像学表现不具特异性,单凭影像学难以与其他类型乳腺癌鉴别。NEBC诊断方法已经较为明确,确诊依靠病理学检查中神经内分泌标志物的检测。治疗原则为以手术为主、全身治疗为辅的综合治疗,相较于其他类型乳腺癌,NEBC的疗效较差。因此,寻求特异性高的治疗方法成为当今NEBC研究的主流,多个研究着手于对NEBC基因突变的检测,力求研发出针对其高频突变位点的靶向治疗药物。同时,NEBC预后较差,确诊该病后,应积极治疗并坚持随访,及时发现疾病新的变化或进展。     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

乳腺钙化的X线诊断

根据钙化的大小、形态、数目、分布结合临床及病理资料分析乳腺钙化的 X线平片 ,有助于良恶性病变的鉴别。在111例乳腺钙化中良性病变显示为 78例 ,恶性病变显示为 33例。其结论是乳腺微粒钙化不可认为是乳腺癌的特异性征象 ,也可较多见于乳腺良性病变。如在成簇的微粒钙化中出现多种形态或不规则钙化 ,则提示有恶性诊断的价值