放射治疗与乳腺癌术后乳房重建的现状

目的探讨乳房切除术后放射治疗（简称放疗）与各种乳房重建方式的相互影响关系以及如何选择重建方式和时机。方法检索近年来有关放疗与乳房重建的文献并做综述。结果放疗可能增加乳房重建（自体组织重建或组织扩张器/假体重建）并发症的发生,影响其美容效果;重建乳房亦可能会影响放疗的疗效。结论对于那些乳房切除术后明确需要放疗或已经接受放疗的患者,选择自体组织二期乳房重建;对于乳房切除术同时尚不能确定是否需要进行放疗的患者,选择延迟的即刻重建,或在患者清楚并接受放疗可能带来更高的并发症和美容效果受影响的前提下选择即刻自体组织重建。

Current Status of Postmastectomy Radiation and Breast Reconstruction

Objective To explore the interaction of postmastectomy radiotherapy（PMRT）and breast reconstruction,and elucidate how to choose the type and timing of breast reconstruction.Method Literatures about PMRT and breast reconstruction were reviewed.Results PMRT might increase the incidence of complications and impair the cosmetic satisfaction of breast reconstruction.Breast reconstruction might also compromise the effect of PMRT.Conclusions In patients who will receive or have already received PMRT,the optimal approach is delayed autologous tissue reconstruction after PMRT.If PMRT appears likely but may not be required at the time of mastectomy,delayed-immediate reconstruction may be considered,or immediate autologous tissue reconstruction may be considered in case of patients awareness of the increased complications and impaired cosmetic outcomes from PMRT.