乳房缩小整形术中定点病理的方法及意义

Site-specific Pathology in Breast Reduction Mammoplasty

目的评估定点病理检查方法在乳房缩小整形术中的意义。方法以127例接受乳房缩小整形术的患者为研究对象,根据乳房缩小整形术中不同位置切除的腺体组织进行时钟式定位,分别行术中冰冻病理检查及术后石蜡组织病理检查。病理结果如为阳性,则根据不同的腺体塑形方式及标准化治疗流程制订下一步治疗方案。结果 127例患者中,53例病理结果为腺体增生;7例合并良性纤维腺瘤;1例为导管内原位癌,接受乳腺癌保乳手术后行放、化疗,迄今随诊3年肿瘤无复发。结论在乳房缩小整形术中行定点病理检查能够有效对肿瘤进行准确定位,结合术中腺体塑形方式,可保证肿瘤检出后患者仍能够接受保乳手术,在减少患者创伤的同时辅助术后放疗定位。

Objective To investigate the feasibility and clinical value of site-specific pathology in breast reduction mammoplasty. Methods Totally 127 patients who underwent breast reduction mammoplasty from June 2007 to June 2010 were included. Pathologic specimens were sent for frozen pathology according to the clock-wise method. Patients with confirmed cancer were arranged for conservative breast surgery. Results Of the 127 patients, 53 patients （41.7%） had gland hyperplasia; 7 had fibroadenoma （5.5%）; 1 （0.79%） had ductal carcinoma in situ, who underwent breast conserving surgery, following by chemotherapy and radiotherapy, no relapse was noted during the three-year follow-up. Conclusion Clock-wise method is use- ful to locate the tumor and ensure the patients to receive skin-spared breast resection even cancer is detected.