乳腺癌保乳术中整形性体积易位技术对乳房美容效果的影响

目的:探讨乳腺癌保乳手术中整形性体积易位技术对乳房美容效果的影响。方法:43例经穿刺活检确诊的Ⅰ、Ⅱ期乳腺癌,均行肿瘤扩大切除术及腋淋巴结清扫术。其中,直接缝合组22例,术中对乳腺体缺损不予缝合,直接缝合皮肤关闭创腔;乳腺体重建组21例,术中采用肿瘤整形性体积易位技术,游离剩余乳腺组织瓣,转移修复乳腺体缺损,再缝合皮肤。术后均给予全乳三维适行放射治疗、规范化疗和内分泌治疗。术后3年自拟标准回顾性历史对照分析两组患者乳房美容效果。结果:直接缝合组美容评分4.3分,优良率40.9%(9/22);乳腺体重建组美容评分4.8分,优良率71.4%(15/21),P<0.01,乳腺体重建组乳房美容效果优于直接缝合组。结论:乳腺癌保乳术中采用体积易位技术对乳腺体塑形缝合,术后乳房美容效果更好。

Objective：To explore breast cosmetic results utilizing different repair methods in Zonal excision of breast for stage I and Ⅱ breast cancer patients. Methods：43 cases of Breast cancer patients in stage I and il with pathological diagnosis by core needle biopsy were operated by Zonal excision of breast combined with axillary lymph nodes dissection. Among the total, Wound cavity of 22 cases was repaired by direct skin suture, and of other 21 cases was repaired by breast tissue valve transloeation. All of them were treated with three - dimension eonformal radiotherapy, standard chemotherapy and endocrine therapy after operation. 3 years after partial removal of breast, A retrospective historical controls study has been fulfilled to analyze breast cosmetic resuits between two groups. Results：In direct suture group, the cosmetology score is 4. 3 points and good rate is 40. 9% （9/22）. In breast cosmetic reconstruction group, the score is 4. 8 points and good rate is 71.4% （ 15/21 ）. The breast cosmetic in breast cosmetic reconstruction group is better than in direct suture group significantly （P 〈 0. 01）. Conclusion： It will get better breast cosmetic results among breast cancer patitens after operation to utilize breast body moulding sature according to the requirement of breast cosmetic surgery in Breast - conserving surgery.